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Behaviour Change and Health Improvement In An Organisation


Rachel Lewis and Emma Donaldson-Feilder from Affinity Health at Work demonstrate the use of evidence based practice in relation to enhancing organisational health improvement plans.

Briner et al’s (2009) model of evidence-based practice is well regarded and widely used and therefore seemed an ideal framework for Affinity Health at Work to use when we were invited to help a large transport organisation develop their Health Improvement Plan. 

The aim of the project was to identify what health improvement activities would be best for this organisation and how best to implement these to increase effectiveness.

The purpose of using an evidence-based practice model was to assist the client in taking a rigorous approach in understanding the range of perspectives relevant to its Health Improvement Plan. 

The Briner et al model proposes that four types of evidence be examined: the best available external research evidence, practitioner expertise and judgement, evidence from the local context and perspectives of stakeholders, those who may be affected by the interventions. 


The evidence was collected in a variety of ways:

  • Evaluated external evidence – Literature reviews of academic and practitioner literature were carried out to identify findings regarding health promotion, health improvement, public health and behaviour change literature.
  • Practitioner expertise and judgement – Focus groups were conducted with practitioners from the appropriate disciplines and the data collected was analysed using thematic analysis.
  • Context, local evidence – Interviews with stakeholders within the transport organisation helped to identify facilitators of and barriers to health improvement activities and understand their perspective on what worked well in the organisation.
  • Stakeholders’ preferences or values – A questionnaire survey was used to gather employees’ opinions and main concerns for health behaviour change, barriers and facilitators.


Applying the evidence, the recommendations were:

  • What Health Improvement Plan activities should be focused on
  • Which activities to implement
  • How to implement the activities in the future

Practitioners within the organisation were also given checklists to aid in deciding whether interventions would work in their setting.

The organisation benefited not only from the findings of the work but also the manner in which the work was carried out (see below)


Benefits to the organisation

  • Evidence based approach – Substantial evidence was collected from a variety of sources, thus enabling more informed decisions to be made regarding the activities to be implemented and the best method of putting these into operation
  • Engagement with stakeholders and employees – through interviews and surveys conducted. This engagement would subsequently have helped to engage the necessary employees when putting into effect the health improvement activities
  • Clear feedback on what works – Examining practitioner and academic research and previous projects within the organisation it was possible to identify what health improvement activities have previously been effective
  • Prioritisation – Feedback obtained through surveys and interviews from employees helped to clarify what is a priority for future activities
  • Step by step process and checklist outputs – The organisation was provided with a step by step process for implementing health improvement activities and a checklist to aid in decision making


Using the results

The primary aim of the project was to help the organisation establish which health improvement activities would be most appropriate and how best to implement these to increase effectiveness.

However, the results of the project have also been disseminated more generally and it is hoped that this will benefit other organisations and their employees. 

The project was featured in the London Health Commission’s report on its Call for Evidence on workplace health and wellbeing, which was published in April 2014 and has also received coverage through professional journals and conferences.

The team won the British Psychological Society Division of Occupational Psychology Practitioner of the Year Award 2014 for the project.


To read more about our work, visit the Affinity Health website and find us on Twitter


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