Are Community Coalitions a Better Mechanism to Advance Health Equity? A Narrative Review

Background/Objective: Despite increasing emphasis on health equity in policy, leadership, and program development, meaningful advancement in health equity remains a challenge. A comprehensive review of community health coalition efforts to improve health equity has not been conducted. In this narrative review, we examine what evidence exists that community health coalitions can advance health equity, and whether coalitions are a preferred approach to address health equity. Methods: PubMed, CINAHL, PsycINFO, and Web of Science were searched for peer-reviewed, English articles with no date restrictions. In total, 1256 records were screened, of which 1163 were excluded for duplicate publications, no coalition or coalition-based intervention, no relevant outcomes, no emphasis on health equity or disparities, not primary literature, or unavailable full text. The remaining 93 articles are presented as a table of interventions based on outcomes. Further, evaluations of coalition effectiveness with controls are reviewed. Results: Populations of interest were racial and ethnic minorities, women and girls, low socioeconomic status communities, rural and urban areas, older adults, and LGBTQ groups. The most commonly reported results were changes in health outcomes or behaviors and community or organizational policy. Few studies were randomized, double-blinded, or controlled trials. This is not unexpected given the difficult nature of evaluating community interventions. Very few studies evaluated the effectiveness of a coalition-based intervention as compared to organizational interventions. Conclusion, Impact, & Implications: Available literature suggests that health coalitions influence health outcomes, policies, and important social determinants of health in populations affected by health inequity. However, community intervention studies pose a unique challenge for high quality evaluation. While health coalitions have a positive influence on health equity, more research is needed to determine the advantages of health coalition interventions versus organizational interventions.

Enhanced Sentinel Surveillance System for COVID-19 Outbreak Prediction in a Large European Dialysis Clinics Network

Accurate predictions of COVID-19 epidemic dynamics may enable timely organizational interventions in high-risk regions. We exploited the interconnection of the Fresenius Medical Care (FMC) European dialysis clinic network to develop a sentinel surveillance system for outbreak prediction. We developed an artificial intelligence-based model considering the information related to all clinics belonging to the European Nephrocare Network. The prediction tool provides risk scores of the occurrence of a COVID-19 outbreak in each dialysis center within a 2-week forecasting horizon. The model input variables include information related to the epidemic status and trends in clinical practice patterns of the target clinic, regional epidemic metrics, and the distance-weighted risk estimates of adjacent dialysis units. On the validation dates, there were 30 (5.09%), 39 (6.52%), and 218 (36.03%) clinics with two or more patients with COVID-19 infection during the 2-week prediction window. The performance of the model was suitable in all testing windows: AUC = 0.77, 0.80, and 0.81, respectively. The occurrence of new cases in a clinic propagates distance-weighted risk estimates to proximal dialysis units. Our machine learning sentinel surveillance system may allow for a prompt risk assessment and timely response to COVID-19 surges throughout networked European clinics.

EXPRESS: Expatriate Work Role Engagement and the Work-Family Interface: A Conditional Crossover and Spillover Perspective

How intertwined are expatriates with their families? And what makes some expatriates better than others at leveraging positive or compensating for negative influences from their family life? Drawing on conservation of resources, crossover and spillover theories, we examine when partner family role adjustment influences expatriates’ family experiences, and how and when these experiences translate into expatriate work role engagement. Using data from 105 expatriate-partner dyads at two time points, we establish the key personal resource of general self-efficacy as a boundary condition for crossover and spillover. We find that expatriates with high self-efficacy experience no crossover between partner family role adjustment and expatriate family role adjustment, and positive spillover between their family role engagement and their work role engagement. By contrast, expatriates with low self-efficacy experience strong crossover between partner family role adjustment and expatriate family role adjustment, and negative spillover between their family role engagement and work role engagement. Our results suggest that the way in which the family domain influences expatriate work role engagement depends on general self-efficacy. We contribute to conservation of resources, crossover and spillover theories, and the work-family interface during expatriation. Our results also pinpoint organizational interventions to improve expatriates’ work role engagement.

Line managers' middle-levelness and driving proactive behaviors in organizational interventions

PurposeThis paper explores line managers' proactive work behaviors in organizational interventions and ascertains how their management of their middle-levelness by aligning with the intervention, or not, influences their proactive work behaviors.Design/methodology/approachThe authors’ findings are based on thematic analysis of 20 semi-structured interviews of university heads of departments responsible for managing organizational interventions.FindingsThe authors found that line managers engaged in a range of proactive work behaviors to implement the organizational intervention (i.e. “driving proactive behaviors”). Furthermore, line managers tended to engage in driving proactive behaviors when they aligned with the organizational intervention, but not to when unconvinced of the intervention's validity.Practical implicationsThese findings highlight the importance of senior management and HR investing sufficient time and quality in the preparation phase to ensure all actors have a shared understanding of the organizational interventions' validity.Originality/valueThis is the first study to explore line managers' proactive work behaviors to implement an organizational intervention, and how the line managers' management of their middle-levelness influence these proactive work behaviors.

The Relational Fit in Organizational Interventions—What Can Organizational Research Learn from Research in Psychotherapy?

There is a growing interest in organizational interventions (OI) aiming to increase employees’ well-being. An OI involves changes in the way work is designed, organized, and managed. Studies have shown that an OI’s positive results are increased if there is a good fit between context and intervention and between participant and intervention. In this article, we propose that a third fit—the Relational Fit (R-Fit)—also plays an important role in determining an intervention’s outcome. The R-Fit consists of factors related to 1) the employees participating in the OI, 2) the intervention facilitator, and 3) the quality of the relation between participants and the intervention facilitator. The concept of the R-Fit is inspired by research in psychotherapy documenting that participant factors, therapist factors, and the quality of the relations explain 40% of the effect of an intervention. We call attention to the importance of systematically evaluating and improving the R-Fit in OIs. This is important to enhance the positive outcomes in OIs and thereby increase both the well-being and productivity of employees. We introduce concrete measures that can be used to study and evaluate the R-Fit. This article is the first to combine knowledge from research in psychotherapy with research on OIs.

Positive Participatory Organizational Interventions: A Multilevel Approach for Creating Healthy Workplaces

In the following perspective paper, we argue for the importance of conducting research on positive participatory organizational interventions. We propose that these types of interventions are important because they not only focus on eliminating or reducing adverse job demands but focus also on developing job resources. To achieve the best effects, actions should be taken to address demands and resources at the individual, group, leader and organizational levels. We furthermore suggest that the participatory intervention process itself may also build resources at these four levels.

Direcionamento da visibilidade nas mídias sociais a partir da estratégia de baralhamento / Targeting visibility on social medias from the shuffling strategy

Our research is inserted in the context of relationship with publics in digital environments. Specifically, it is related to strategies for directing visibility in social medias, triggered when identifying risks or emerging issues (in society and/or in the media) that may go against how organizations want to be perceived (Da Silva & Baldissera, 2019). We understand that visibility, in its broadest sense, is usually indicated as the most incident desire of organizations in social media (Silva, 2020). However, studies that deal with this theme tend to disregard the fact that being in the spotlight can be negative, especially when the correlated issues and approaches are unfavorable or uninteresting. In these cases, organizations, opportunely, activate a set of strategies that try – along the dynamics of relationship and interaction with the publics – to direct visibility towards something that seems (more) opportune to them (Da Silva, 2018). The purposes of this article are reflect on the notions and practices of (in)visibility in social medias and present initiatives adopted by organizations aiming at shuffling and misunderstanding a situation, as a strategy to direct visibility in these medias. Symbolic interactionism is the epistemic foundation of research. Discussions are based on reports from professionals working in agencies affiliated to the Brazilian Association of Digital Agents, collected in depth interviews by Da Silva (2018), which evidenced such initiatives. The results reveal a set of eight possibilities from which associations seek to lead visibility to approaches that do not conflict with the positioning desires or that are less harmful in comparison with other senses seen, or with this potential. We are referring to the deviation of the focus towards positive guidelines, the generation of facts, the promotion of other approaches based on paid investment, the infiltration of organizational actors in the discussions, the “purchase of audience”, the incidence or hiring of influencers, the competitor imbalance, and the optimization of the desired visibility in search engines. Such findings signal professionalization at the sociotechnical level, since there are a number of alternatives adopted in order to preserve organizations. We observed these results with concern and problematized them from the perspective of the public interest, because there are ethical distortions that can cause significant damage to society. The practices learned show and allowed us to perceive that there are many dynamics that are part of the problem we have discussed. All these paths disturb us. In these cases, there is a certain disqualification of the place (and strength) of the subjects, who seem to be led/perceived almost like “puppets”, in a conception that organizational interventions lead to certain behaviors, which have already been predicted. An action-reaction idea prevails. It is important to emphasize that, if, on the one hand, appropriations of visibility targeting strategies can enhance the communication processes of organizations and their public presence in the sense they want, on the other hand, they can lead organizations to different levels of "omission" and/or concealment of matters of public interest, ranging from moral issues to legal commitments. This situation is enhanced, in the current context, due to the incipient initiatives that aim to observe and, in some way, monitor these (potentially) abusive practices, such as the distortion of information, the dissemination of false news and the act of spreading rumors (Henriques & Silva, 2014). Furthermore, “most of the time, surveillance initiatives end up discovering abusive practices long after the effects of those actions, which implies a research that is always focused on the past” (Henriques & Silva, 2020: 49).