Exploring Alcohol Workplace Policies and Practices through the Lens of Health Promotion Theory

Alfred, Lolita and Limmer, Mark and Morris, Abigail (2022) Exploring Alcohol Workplace Policies and Practices through the Lens of Health Promotion Theory. PhD thesis, Lancaster University.

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Abstract

Background & Aim: Against a backdrop of avoidable alcohol-related mortality, morbidity, and social problems; literature has identified that alcohol-related problems are also experienced in workplaces. Workplaces are regarded as an arena with untapped potential for supporting health promotion and alcohol harm reduction for employees. One of the ways that workplaces can contribute is through developing alcohol workplace policies (AWPs) and practices that are health-promoting. There is however a paucity of empirical theoretically underpinned research on the extent to which AWPs and practices are informed by health promotion principles. The current PhD study aims to address this gap. Methodology & Methods: A qualitative case study of two public sector organisations in England was conducted. It drew on data collected from documents in both organisations, and 16 semi-structured interviews with policymakers and non-policy makers. Data analysis was undertaken using Ritchie and Spencer’s (1994) Framework Analysis Method. All processes of data collection, analysis and interpretation were informed by a health promotion theoretical framework which comprised of Bronfenbrenner’s Ecological Systems Theory (1979) and the WHO Healthy Workplace Framework (2010). Results: Three themes were identified from the data, namely, Misaligned Voices; The Grey Areas; and The Wider Determinants, Meanings and Purpose of Alcohol. These themes encapsulated how AWPs and practices show persistent tensions regarding alcohol treatment versus prevention, and discipline versus treatment. The existence of AWPs and the lingering fear that these are more about discipline and performance has contributed to the unintended consequence of driving alcohol problems underground rather than promoting employee early help-seeking. The themes also capture how misaligned and divergent views around ‘alcohol problem framing’ are inadvertently contributing to inconsistent ways of managing alcohol problems in the workplace. Using the health promotion theoretical framework enabled the study to uncover the entangled influences of personal, socio-cultural, environmental/workplace and politico-economic factors on employee drinking, and on how AWPs and practices are shaped in the workplace. Conclusion: The thesis concludes by examining the implications of the case study findings, and makes recommendations for future research, policy, and practice. It acknowledges that workplaces provide support for and investment in systems of treatment for individuals who may be dependent on alcohol. However, the focus on prevention and the overall health-promoting potential is limited because of the misaligned voices, grey areas and unintended consequences of AWPs. Workplaces need to consider policy and practices around alcohol from a wider health promotion theory-based perspective. The thesis contributes to the body of knowledge by presenting a health promotion theoretically underpinned ‘10 Point Checklist’ that workplaces can use alongside their existing AWP development, implementation, and evaluation processes. This will enable a more proactive, upstream approach towards employee alcohol health promotion and prevention of alcohol problems.