Shifting cultures of silence: a knowledge-integrated learning approach to organisational responsiveness on alcohol prevention - a longitudinal qualitative process study in Swedish workplaces

Organisational responses to alcohol-related risks in the workplace are often constrained by cultural norms, emotional discomfort, and unclear preventive responsibilities. Although formal alcohol policies are common, their implementation is hindered by stigma and silence. This study examines how a knowledge-integrated learning process can support Human Resource (HR) professionals in reducing organisational tolerance for risky drinking and strengthening preventive responsiveness. A longitudinal qualitative intervention was conducted between 2022 and 2025 across seven large organisations in southwest Sweden. Fourteen HR professionals participated in three facilitated Learning Labs designed as dialogical arenas for knowledge input, reflection, and collaborative problem-solving. Data sources included a web survey of 5,868 managers, observational field notes, and transcripts from the Learning Labs. Reflexive thematic analysis was used to explore how HR participants’ understanding of alcohol prevention developed over time. Five mechanisms shaped the learning process: dialogical co-created learning, experience-based reflection, emotional and cultural barriers, structural ambiguity and unclear mandates, and managerial insecurity. These mechanisms evolved across three phases: (1) emotionally grounded reflection on cultural silence, (2) conceptual reframing of preventive responsibility, and (3) method-driven application through tools and routines. Over time, HR participants shifted from reactive uncertainty to more proactive and structurally informed approaches to alcohol prevention. The study shows how sustained, participatory learning can enhance HR professionals’ preventive reasoning and ability to interpret alcohol-related risks. Integrating emotional, cultural, and structural dimensions enables a move beyond compliance-focused policy work toward more coherent and responsive preventive reasoning and approaches. The findings highlight the value of dialogical, culturally attuned, and structurally supported learning processes in strengthening workplace alcohol prevention.