Carrying out an RCT in a workplace
The big takeaway
- Goal-based interventions can improve working adults’ wellbeing when focused towards goals that are aligned with personal values and have been chosen by the individual.
- These interventions do not have to be long-term or elaborate – a brief, online self-help intervention can also be effective.
- Wellbeing interventions proven in clinical settings can be effectively adapted for use in workplace settings with only minor alterations.
Who was involved?
- Researchers at Royal Holloway, University of London
- 330 public sector employees across the UK from Environment Agency (EA), Department for Environment, Food and Rural Affairs (DEFRA), Her Majesty’s Courts and Tribunals Service (HMCTS).
One way to improve the wellbeing of working adults is to provide brief training in setting and pursuing personal life goals. This was proven in a recent randomised controlled trial of a new online training programme developed at Royal Holloway University of London, involving 330 public sector employees across the UK. Participants reported improved wellbeing (greater life satisfaction, more positive emotions, less negative emotions, and a greater sense of purpose) five weeks after starting the programme and three months later.
Timings and cost
The trial ran from 2015-2016, with outcomes published in the Journal of Occupational and Organizational Psychology in September 2018. The trial was run as a thesis project for the Doctorate in Clinical Psychology study, so no external funding was sought or received. £200 was spent on a website hosting.
What was the goal?
The online training was designed to improve the wellbeing of working adults across the UK. The trial recruited 330 employees from Civil Service organisations across the UK, following the precedent set by the Whitehall-II cohort studies to recruit from large public sector organisations for studies of employee health and wellbeing.
Our aim was to conduct a rigorous trial to find out if a new online version of a goal-setting and action-planning (GAP) training programme could actually make an improvement to working adults’ wellbeing. The new online version had been adapted from a booklet/group-based treatment programme already used successfully in mental health service and community settings. We wanted to create an online resource that was widely accessible (at work or home) and relatively low-cost to deliver. The original material was adapted so it could be delivered online, read during busy working days, and included relevant working adult case studies.
Professor MacLeod and previous students had written and tested the goal-setting and action-planning (GAP) programme in mental health services and community settings. Dr Oliver used the booklet and group-session materials from those interventions and adapted them for use online by working adults. Dr Oliver then contacted former work colleagues in the Civil Service, at Board level (HR Directors/Director-Generals) who kindly agreed to take part in the trial. 330 participants were recruited in three waves in late 2015 and early 2016, then randomised to either receive the intervention immediately (intervention) or receive it after a wait period (waitlist control).
Wellbeing measures (Positive and Negative Affect Schedule, Satisfaction with Life Scale, Flourishing Scale) were taken before and after the intervention period, and again three months’ later. Participants were offered a 20-minute support phone call, but only 12 participants took up this offer.
Positive outcomes were therefore achieved with minimal resources, showing the programme to be effective as a self-help intervention.
Outcome data were analysed in two ways: intent-to-treat (all those who were randomised into each condition) and per protocol (those who completed the intervention). To account for drop-out, the last observation was carried forward for the intent-to-treat analysis.
The measures above are validated and suitable for robust statistical analysis. However, we wanted to include a further context-specific measure that was relevant to the participating Government departments, to give feedback on how the intervention had helped their employees. At each time point in the trial, we also asked participants the four well-being questions from the Civil Service People Survey. Each year, government departments are benchmarked against each other for employee wellbeing, based on employee responses to these four questions.
The two main challenges were recruitment and adherence. The reality of busy working lives meant we needed to recruit from three departments in three waves to get enough participants to generate statistically valid outcomes, including at three-month follow-up. Once people had signed up, the majority started the programme but we were surprised that only a relatively small proportion of participants reached the final module of the programme. This suggests we underestimated how much workloads would affect adherence even to a brief, bite-size intervention designed to be a positive help to work stress. In the journal article (see link below) we suggest a number of ways we could try to improve adherence in any future trial.
Participants reported improved wellbeing (greater life satisfaction, more positive emotions, less negative emotions, and a greater sense of purpose) five weeks after starting the programme and three months later. The size of the effect on participant’s well-being was small, but within a trial of this size, and given that the intervention was voluntary, self-help, delivered online at low-cost, and most people did not complete the full intervention, we were delighted that there was a positive effect at all!
By asking the four well-being questions from the Civil Service People Survey, we were also able to demonstrate to the Government departments involved that the improvement in participants’ wellbeing was not just evident on academic measures of wellbeing, but was also evident using the Civil Service’s own method of measuring wellbeing. Our group of participants started either below, or at, the 2015 Civil Service benchmark for well-being before the intervention. However, by follow-up, the participant group had moved above the benchmark on all four questions, reporting higher levels of wellbeing than the average civil servant in 2015.
We do not have fixed plans for further trials, but the next step would be trialling the programme within a range of workplace sectors, including the private sector. A next step would be to see if even greater results can be achieved if we can find ways to enable people to complete more of the programme when they start it, as well as finding ways of making it more attractive to people to start. Given the successful trial outcome, one option was to consider making the programme available to purchase. However, we decided our ethos and values were not aligned with trying to make commercial gains, so we are not intending to ‘sell’ the programme and we requested a licence on the journal article to prevent the information there being used for commercial gain by others. Organisations that are interested in using the programme are welcome to contact us for further information.
Open access journal article – Oliver, J. J., & MacLeod, A. K. (2018). Working adults’ well‐being: An online self‐help goal‐based intervention. Journal of Occupational and Organizational Psychology, 91, 665-680.
Thesis (including details of the Civil Service People Survey well-being questions and outcomes)– Oliver, J.J. (2016). A Randomised Controlled Trial of a Goal-Setting and Planning Intervention to Improve Working Adults’ Well-Being.
Dr Jeremy Oliver – firstname.lastname@example.org
Professor Andrew MacLeod – email@example.com