© 2012 | WORK, FAMILY & HEALTH NETWORK

Positive and Negative Perceptions of

Diffusion Related Attributes from

Users of a Workplace Intervention:

Evidence from the WFHN Study

Ginger C Hanson, PhD

Bonnie A. Leeman-Castillo, PhD

James W. Dearing, PhD

Mary L. Durham, PhD

© 2012 | WORK, FAMILY & HEALTH NETWORK

Members

The University of Minnesota

Penn State University

Harvard University

Portland State University

Purdue University

Kaiser Permanente

Michigan State Universtity

RTI International

University of Southern California

Supporting Partners

The Eunice Kennedy Shriver National Institute of Child

Health & Human Development (NICHD)

Regina Bures, Program Official

Rosalind Berkowitz King, Project Scientist

Centers for Disease Control & Prevention (CDC)/

National Institute for Ocupational Safey & Health

(NIOSH)

Casey Chosewood,

Senior Medical Officer for Total Worker Health

National Institute on Aging

Lis Nielsen, Program Official

The Office of Behavioral and Social Sciences Research

(OBSSR)

Tisha Wiley, Program Official

Grants from the William T. Grant Foundation and the

Administration for Children and Families have provided

additional funding.

Work-Life Innovations

■ The number of employers who are offering increased

control over where and when employees work

continues to increase (Matos & Galinsky, 2014)

■ A growing number of vendors offering work-life

innovations that have not been rigorously tested

■ There is a growing interest among work-life

researchers in developing and/or testing new work-life

innovations (Bailyn et al., 2006 Hammer et al., 2011, Kelly et

al., 2011, Moen et al., 2011, & Rapport et al., 2002)

Dissemination and Diffusion

■ In other fields (medicine, social work), many evidence-

based innovations are developed but do not get widely

adopted by practitioners

■ Dissemination: purposive passive and active

communication (push) to potential adopters (Dearing &

Kreuter, 2010)

■ Diffusion: reaction of target segment of adopters as a

result of curiosity, perceived value, ease of access,

and positive status association (pull) (Dearing, 2008)

Creating Pull by Studying Perceptions of Intervention Attributes

■ Effectiveness is just one of several attributes that

affect adoption decisions

■ Other important attributes: cost, simplicity,

compatibility, observability, trialability (Rogers, 1995)

■ Study of attributes can:

■ Inform modifications that may increase diffusion

■ Predict or explain diffusion

■ Help shape dissemination messages

Innovation Attributes for Diffusion (Rogers, 2010)

■ Effectiveness: Achieves the objectives for which it was designed

■ Observability: Outcomes easily seen by others

■ Adaptability: Can be customized to better meet adopters needs

■ Compatibility: Consistent with values & needs of users, current

policies and procedures, workplace culture

■ Cost: Resources, FTE, time, lost productivity, opportunity costs

■ Simplicity: How difficult it is to understand, learn, use

■ Trialability: Ability to try out little by little or without incurring cost

■

© 2012 | WORK, FAMILY & HEALTH NETWORK

About the larger study & intervention

Industry Partners

STAR Office:“TOMO” – Information Technology (IT) division – Large, well-established company – One primary location with other satellites – Some work groups get STAR, others continue

usual practice

STAR Healthcare: “LEEF” – For-profit Health Care (HC) provider – Included 30 extended care facilities total – Some sites get STAR, others continue usual

practice

More about methods Bray et al., (2013) RTI Press

8

STAR Office Rollout: IT

Wave 1 survey

Sludge Session Culture Clinic Session

Managers Only Session

Wave 2 survey

Leadership Education Session

Kick-Off Session

Mgr

training

&

tracking

Mgr

tracking

Do

Something

Scary Poll

Forum Session

Sludge

Eradication

Poll

9

More about logic model in King et al. (2012). Handbook of Occupational Health & Wellness

More about the intervention in Kossek et al. (2014). Organizational Dynamics

Customization of STAR for Health Care

■ Customized messages: ■ Changed some guideposts (e.g., ‘Every day feels

like your day off.’)

■ Added guiding principle for any change:

■ Safe, Legal, and Cost Neutral

■ Focused on handling schedule conflicts, “call outs”

and shift trades in fair, transparent way

■ Customized process ■ Steering teams ■ Broke up sessions—more and shorter

■ More about customization in Kossek et al. (In press). Occupational Health

Disparities among Racial and Ethnic Minorities

10

© 2012 | WORK, FAMILY & HEALTH NETWORK

Qualitative work on diffusion related

attributes of STAR

12

STAR/T Attributes Study Methods

Using formal feedback interviews

Subset of LEEF Administrators (5) & TOMO Managers (5)

Identify evaluative phrases

Unit=Interviewees answer

Refers to STAR

Valiance (+ or -)

Coded attribute (e.g. effectiveness, observability, adaptability,

compatibility, cost, simplicity, trialability)

Identified sub-themes by attribute to illustrate + and - examples

Two coders code each transcript and discuss disagreements

Effectiveness

Effectiveness Positive

■ Both Industries

■ WeSupport tracking helped managers see where they were doing well and where

there was room for improvement

■ STAR reduced sludge and sludge defensiveness thereby reducing guilt

■ STAR: Office

■ Telecommuting and schedule control helped employees use their time more

efficiently to meet work and family demands.

■ STAR reduced unnecessary participation in meetings

■ Managers set meaningful timelines rather than creating unnecessary urgency

■ Star: Healthcare

■ Giving staff more decision authority and schedule control allowed them to generate

useful solutions to long standing staffing problems

■ STAR helped to increase employee satisfaction

Effectiveness: Negative

■ Star: Healthcare

■ Conflicting expectations between STAR and leadership caused administrator confusion and stress

Leadership STAR

Observability

Observability Positive

■ STAR: Office

■ Changes in the level of telecommuting and schedule control are

noticeable, but there is variability in use

■ When employee can manage their own time they are more

willing to work long hours under tight deadlines

■ Star: Healthcare

■ Allowing employees to trade shifts or find their own coverage

decreased unplanned schedule gaps (e.g., call outs, tardies)

■ Improved communication within teams and with manager

■ People are more comfortable having professional discussions about

issues and concerns (reduced sludge and increase decision authority)

■ “Sludge” and the ability to make any change that is “safe, legal, and

cost neutral” have entered into the everyday language

Observability: Negative

■ STAR: Office

■ A small number of employees have performance issues in a STAR

environment (e.g., not being accessible, missing deadlines)

■ Some people missed the opportunity to have casual face-to-face

conversations about the work

■ Some people still felt it was necessary to provide a “legitimate”

excuse for using schedule control or flexibility

■ Star: Healthcare

■ There was concern that the increased schedule control was a tactic

to reduce overtime, which some staff depend on

■ The norms emphasizing punctuality were difficult to change

Compatibility

Compatibility: Positive

■ Both Industries

■ The WeSupport tracking helped managers achieve desired changes

such as supporting employees in the way they knew they should

■ STAR legitimized consistent use of informal practices that were

already used by some supervisors

■ STAR: Office

■ Telecommuting and schedule control fit employee’s needs

■ Fits the way work is done today: remote access, smart phones, etc

■ Star: Healthcare

■ The organization wanted to empower employees to make decisions

and STAR helped them achieve that

■ Communication with interviewees about START assures that new

candidates are a good fit and improves retention

Compatibility: Negative

■ Both Industries

■ Mangers/Administrators did not see enough evidence that leadership

fully supported STAR

■ STAR: Office

■ There is a need for teams to agree on expectations about

accessibility

■ Sometimes the nature of work makes telecommuting difficult

■ Star: Healthcare

■ Workload was a barrier to participation in the STAR sessions

■ Some STAR principles were perceived by administrators to be

inconsistent with some leadership goals

Adaptability

Adaptability: Positive

■ STAR: Office

■ Some managers initiated extra meetings or provided additional

clarification

■ When the is job “done”

■ When employees can utilize their schedule control and how much is

appropriate

■ Expected response time on an email

■ When and how to let others know when you are available

■ Star: Healthcare

■ Some facilities added additional sessions

■ Some facilities added STAR concepts to new employee

orientation

Adaptability: Negative

■ Both Industries

■ Organizations should develop a plan to assure coverage during

popular vacation periods like holidays

■ Give managers strategies, extra training, and tools to deal with

performance issues, particularly for low performers

■ STAR: Office

■ Assess what the organization is already doing right and recognize

that during the sessions.

■ Assess manager’s adoption of STAR, provide extra coaching where

necessary to move managers from a controlling to a trusting style.

■ Star: Healthcare

■ Actively involve everyone (all units and levels)

■ Provide examples of how greater schedule control can be achieved in

customer service jobs

Simplicty

Simplicity: Positive

■ Star: Healthcare

■ Use of the iPod for the WeSupport tracking was simple

Simplicity: Negative

■ STAR: Healthcare

■ It is difficult for administrators to try to manage the facility and

implement STAR

■ The number of people not in the loop made it challenging for

administrators to move changes forward.

■ There was added complexity for the scheduler when staff

wanted a day off but did not find their own replacement or did

not find a replacement that would be cost neutral

■ It was challenging to find a balance between STARs principles

of greater schedule control and corporate goals about safety

and continuity of care

Recommendations for Both Industries

■ WeSupport and Sludge Sessions are highly valued and should

not be omitted

■ Encourage active participation of leadership and managers in

changing policies and practices

■ Give managers strategies, extra training, and tools to deal with

performance issues, particularly for low performers

■ Organizations should develop a plan to assure coverage

during popular vacation periods like holidays

■ Provide more examples and guidelines about schedule control

■ Make plans for sustainability early (e.g., designated STAR

personnel, booster sessions, calendar reminders for

WeSupport principles, employee orientation)

Recommendations for STAR: Office

■ Assess what the organization is already doing right and

recognize that during the sessions

■ Encourage teams to agree on expectations about accessibility

(e.g, core hours, response time to emails, IMs, texts, etc.) so

that they can coordinate their work

■ Recognize that some people value face-to-face interactions,

provide examples of how to facilitate this

■ Assess manager’s adoption of STAR, provide extra coaching

where necessary to move managers from a controlling to a

trusting style.

Recommendations for STAR: Healthcare

■ Facilitating the participation of all employees–make adjustment

to reduce workload barriers

■ Develop a better process for aligning leadership goals and

metrics with STAR (e.g., more leadership participation in the

roll out, and a reassessment of metrics and goals that need to

be modified)

■ Understand and address concerns or issues of mistrust early

■ Provide Administers and Schedulers more support regarding

how to reduce schedule gaps

■ Incorporate a greater understanding of how increased

schedule control can be achieved in an environment where

continuity of care and safety are critical

Work, Family, and Health Study DATA

www.WorkFamilyHealthNetwork.org

DATA DOCUMENTATION

Measures books

CAPI survey instruments

Description of worksites

DATA FORTHCOMING

Public Use Data @ ICPSR

Restricted-Access Data Application Instructions

Thank you!

■ Ginger Hanson at ginger.c.hanson@kpchr.org

■ More at www.workfamilyhealthnetwork.org

■ What QUESTIONS do you have?

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