A multi-level approach to workplace wellbeing: Integrating organizational and ecological factors within the 6SQuID intervention development framework

Workplace stress remains a significant public health concern, particularly in high-pressure work environments like contact (call) centers. The development of existing workplace health interventions often prioritizes individual behavior change without addressing broader organizational determinants of stress, limiting their effectiveness. This study aimed to understand and address these determinants by applying the Six Steps in Quality Intervention Development (6SQuID) framework, integrating the socioecological model (SEM) and Schein’s organizational culture model, to co-produce and implement an intervention targeting employee stress and wellbeing in a UK-based contact center. A longitudinal case study approach was used, involving four workshops and two focus groups. Through structured workshops, managers (n=7) identified key workplace stressors in order to co-produce a theory of change, theory of action, and an action plan to address them. Codebook thematic analysis of focus groups (n=13; seven managerial and six non-managerial staff) found that action plan implementation resulted in positive perceived changes in workplace culture,
employee wellbeing and stress. They also highlighted enhanced engagement, stronger managerial support, and greater alignment of organizational practices with employee wellbeing. To our knowledge, this is the first study to explicitly integrate ecological and organizational culture factors into workplace intervention development using the 6SQuID framework. This study underscores the importance of embedding ecological and cultural considerations into workplace interventions to increase their potential for effectiveness and
sustainability. Findings provide a model for organisations seeking to systematically address workplace stress, demonstrating the utility of the use of 6SQuID and co-production in facilitating structural and cultural change.