What Works for Whom in Which Circumstances? Evaluating Organisational Interventions Using Realist Evaluation

Organisational interventions that aim to improve working conditions are the recommended approach for improving employees’ health and wellbeing. This thesis tries to advance the knowledge of how to design, implement, and evaluate organisational interventions. To achieve this, this thesis seeks to improve the understanding of ‘how to’ apply realist evaluation in organisational interventions, and to explore ‘what worked/might work/works for whom in which circumstances’ in organisational interventions. Chapter 2 is a realist synthesis, it identifies and synthesises empirical evidence from 28 organisational intervention studies into six Context-Mechanism-Outcome (CMO) configurations based on the mechanisms of implementation adherence, communication, employees’ participation, senior management support, middle management support, and external consultants/researchers support. Chapter 3 uses the qualitative evidence from the planning phase of a participatory organisational intervention in the US food service industry and develops four initial CMO configurations based on the mechanisms of participation, leadership commitment, communication, and tailoring the intervention to fit the organisational context. Chapter 4 uses the qualitative evidence from the implementation and evaluation phases of the same participatory organisational intervention and tests of these initial CMO configurations, participation. Finally, based on the lessons learned from using realist evaluation in the participatory organisational intervention in the US food service industry (chapters 3 and 4), and by using the contexts, mechanisms, and outcomes identified in chapter 2, chapter 5 proposes an evaluation model. The proposed model provides guidance on when, why, and how to develop and test CMO configurations for a comprehensive list of crucial intervention mechanisms. Overall, the knowledge generated on ‘how to’ apply realist evaluation and on ‘what worked/might work/works for whom in which circumstances’ in this thesis can be used to design, implement, and evaluate future organisational interventions.