A Multilevel Model of Organizational Health Culture and the Effectiveness of Health Promotion

Abstract

Purpose.

Organizational health culture is a health-oriented core characteristic of the organization that is shared by all members. It is effective in regulating health-related behavior for employees and could therefore influence the effectiveness of health promotion efforts among organizations and employees. This study applied a multilevel analysis to verify the effects of organizational health culture on the organizational and individual effectiveness of health promotion.

Design.

At the organizational level, we investigated the effect of organizational health culture on the organizational effectiveness of health promotion. At the individual level, we adopted a cross-level analysis to determine if organizational health culture affects employee effectiveness through the mediating effect of employee health behavior.

Setting.

The study setting consisted of the workplaces of various enterprises.

Subjects.

We selected 54 enterprises in Taiwan and surveyed 20 full-time employees from each organization, for a total sample of 1011 employees.

Measures.

We developed the Organizational Health Culture Scale to measure employee perceptions and aggregated the individual data to formulate organization-level data. Organizational effectiveness of health promotion included four dimensions: planning effectiveness, production, outcome, and quality, which were measured by scale or objective indicators. The Health Promotion Lifestyle Scale was adopted for the measurement of health behavior. Employee effectiveness was measured subjectively in three dimensions: self-evaluated performance, altruism, and happiness.

Analysis.

Following the calculation of descriptive statistics, hierarchical linear modeling (HLM) was used to test the multilevel hypotheses.

Results.

Organizational health culture had a significant effect on the planning effectiveness (β = .356, p < .05) and production (β = .359, p < .05) of health promotion. In addition, results of cross-level moderating effect analysis by HLM demonstrated that the effects of organizational health culture on three dimensions of employee effectiveness were completely mediated by health behavior.

Conclusion.

The construct connections established in this multilevel model will help in the construction of health promotion theories. The findings remind business executives that organizational health culture and employee health behavior help improve employee effectiveness.

Keywords

Organizational Health Culture Organizational Effectiveness of Health Promotion Health Behavior Multilevel Model Prevention Research Manuscript format: research Research purpose: modeling/relationship testing Study design: quantitative research Outcome measure: productivity,absenteeism,other financial/economic Setting: workplace Health focus: fitness/physical activity,intellectual health,social health Strategy: culture change Target population age: adults Target population circumstances: education/income level

Get full access to this article

View all access options for this article.

References

DeJoy

Wilson

. Organizational health promotion: Broadening the horizon of workplace health promotion. Am J Health Promot. 2003;17:337–341.

Weiner

Lewis

Linnan

. Using organization theory to understand the determinants of effective implementation of worksite health promotion programs. Health Educ Res. 2009;24:292–305.

Aydin

Ceylan

. What is the joint effect of employee satisfaction and customer orientation on the organizational culture in metalworking manufacturing? Int J Hum Resour Manage. 2011;22:1203–1215.

Golaszewski

Hoebbel

Crossley

. The reliability and validity of an organizational health culture audit. Am J Health Stud. 2008;23:116–142.

Shahzad

Luqman

Khan

Shabbir

. Impact of organizational culture on organizational performance: An overview. Interdiscip J Contemp Res Bus. 2012;3:975–985.

Gibson

Ivancevich

Donnelly

Konopaske

. Organizations: Behavior, Structure, Process. 11th ed. London, United Kingdom: McGraw Hill Co; 2003:32.

Wiener

. Forms of value systems: A focus on organizational effectiveness and cultural change and maintenance. Acad Manage Rev. 1988;13:534–545.

Brian

Stanley

Achilles

Christopher

. Organizational culture and effectiveness: A study of values, attitudes, and organizational outcomes. J Bus Res. 2009;62:673–679.

Rashid

Zabid

Sambasivan

Johari

. The influence of corporate culture and organisational commitment on performance. J Manage Dev. 2003;22:708–772.

10.

O'Leary

Stewart

. Governance factors affecting internal auditors' ethical decision-making: An exploratory study. Manage Aud J. 2007;22:787–808.

11.

Robbins

. Organizational Behavior: Concepts, Controversies and Applications. Englewood Cliffs, NJ: Prentice-Hall; 1998.

12.

O'Reilly

Chatman

Caldwell

. People and organizational culture: A profile comparison approach to assessing person-organization fit. Acad Mange J. 1991;34:487–516.

13.

Chatman

. Improving international organizational research: A model of person-organization fit. Acad Manage Rev. 1989;14:333–349.

14.

de Lara

PZM

. Should faith and hope be included in the employees' agenda? Linking PO fit and citizenship behavior. J Manage Psychol. 2008;23:73–88.

15.

Tepeci

Bartlett

ALB

. The hospitality industry culture profile: A measure of individual value, organizational culture, and person-organization fit as predictors of job satisfaction and behavioral intentions. Int J Hosp Manage. 2002;21:151–170.

16.

Brian

David

. A quantitative review of the relationship between person–organization fit and behavioral outcomes. J Vocat Behav. 2006;68:389–399.

17.

Kreft

. Are Multilevel Techniques Necessary? An Overview, Including Simulation Studies. Los Angeles, Calif: California State University; 1996.

18.

Maas

Hox

. Sufficient sample sizes for multilevel modeling. Method. 2005;1:86–92.

19.

Bagozzi

. On the evaluation of structure equations models. Acad Mark Sci. 1988;16:76–94.

20.

Fornell

Larcker

. Evaluating structural equation models with unobservable and measurement error. J Mark Res. 1981;18:39–50.

21.

Chen

Chou

Shiau

. The development of Chinese version health promoting lifestyle profile. Chang Gung Nurs. 1997;8:14–21.

22.

Walker

Sechrist

Pender

. The Health-Promoting Lifestyle Profile: Development and psychometric characteristics. Nurs Res. 1987;36:76–81.

23.

Cheng

. The relationships between organizational values, organizational commitment, organizational citizenship behavior, and job performance. Chin J Psychol. 1993;35:43–58.

24.

Luo

. The meaning, measure, and correlates of happiness among Chinese people. Proc NSC Humanit Soc Sci. 1998;8:115–137.

25.

Wen

Chiou

. Methodology of Multilevel Modeling: The Key Issues and Solutions of Hierarchical Linear Modeling. Taipei, Taiwan: Future Career Management Corporation; 2012.

26.

Raudenbush

Bryk

. Hierarchical Linear Models. Thousand Oaks, Calif: Sage Publications; 2002.

27.

Fielding

Piserchia

. Frequency of worksite health promotion activities. Am J Public Health. 1989;79:16–20.

28.

Mathiue

Taylor

. A framework for testing meso-mediational relationships in organizational behavior. J Organ Behav. 2007;28:141–172.

29.

Wen

Chiou

. Multilevel moderated mediation of organizational study: An empirical analysis of organizational innovation climate, organizational commitment and job satisfaction. J Manage. 2009;26:189–211.

30.

Kuo

. The Organization Context and Economic Benefit for the Implementation of Workplace Health Promotion Program. Taipei, Taiwan: National Science Council; 2010.

31.

Sutton

. Health behavior: Psychosocial theories. In: Smelser

Baltes

, eds. International Encyclopedia of the Social and Behavioral Sciences. Oxford, United Kingdom: Elsevier; 2002:6499.

32.

Merrill

Aldana

Pope

. Self-rated job performance and absenteeism according to employee engagement, health behaviors, and physical health. J Occup Environ Med. 2013;55:10–18.

33.

Robbins

. Organisational Behaviour: Global and Southern African Perspectives. Cape Town, South Africa: Pearson South Africa; 2003:100.

34.

Young

West

. Do “good values” lead to “good” health-behaviours? Longitudinal associations between young people's values and later substance-use. BMC Public Health. 2010;10:165.

35.

Kilmann

Saxtonm

Serpa

. Gaining Control and Performance. New York, NY: Free Press; 1985.

36.

Fan

K-T

Yen

L-L

. Health promotion in the workplace: Comparison of the experiences of Taiwan and other countries. Taiwan J Public Health. 2008;27:271–281.

37.

Baker

Israel

Schurman

. The integrated model: Implications for worksite health promotion and occupational health and safety practice. Health Educ Q. 1996;23:175–190.