A realistic evaluation of how small enterprises incorporate an intervention directed at their health and safety management, into their daily practice

Abstract

Small enterprises have difficulties implementing many of the demands they face from occupational health and safety actors. A policy intervention programme called ‘the Prevention Packages’ (PP) was a new Danish initiative to improve occupational health and safety in small enterprises. It was a predefined project consisting of an economic incentive, a written manual about how to conduct a predefined occupational health and safety process and support from a facilitator to guide the process. In this case study, we analyze the implementation process in 12 small enterprises that have conducted a Prevention Package. Realist evaluation was used in our analysis and we draw upon Self-Determination Theory, to understand the internal processes from motivation to action within the enter - prises. The aim of the article is to pinpoint the specific working mechanisms in the programme, the context in the enterprises and in the implementation process that enabled the enterprises to improve their health and safety management as expected in the programme theory. We found that some enterprises were able to implement the intervention as it was designed and we detected three main working mechanisms. Some of the enterprises were able to implement the PP and incorporate the methods into their daily practices. These enterprises worked systematically with their work tasks and their business. The process of implementing the PP became a natural part of their development. Some of the enterprises had an ad hoc approach to their work tasks and if the PP did not apply to the current work task or problem it became difficult to appreciate. The facilitator had an important role in translating and adjusting the process to the specific context of the enterprise. In some enterprises the manager and the employees did not agree on the usability of the PP and the facilitator had to secure a dialogue and mutual understanding and feeling of own - ership for the process. The article concludes that the combina - tion of different policy instruments had greater potentials for motivating the small enterprises to improve their OHS than using a single policy instrument. However the Prevention Packages were implemented differently depending on the context of the enterprise e.g. for the enterprises already working systematically, the implementation process was easier than for the enterprises working in a more ad hoc manner. The results from the article can be useful in the design and implementation of future OHS programmes targeting small enterprises.