Exploring the feasibility of evaluating workplace health and wellbeing initiatives that are free at the point of use for workplaces (WHISPAs)

Abstract Background Workplace health and wellbeing initiatives that are free at the point of use for employers (WHISPAs) are increasingly used to improve employee health and reduce health inequalities. Despite investment in workplace health programmes, evidence of effectiveness remains limited, and there is little consensus on how to evaluate these initiatives. This study explored stakeholder perspectives on the feasibility and design of future evaluations of WHISPAs across the UK. Methods A qualitative study used semi-structured online interviews with stakeholders involved in the development, delivery, commissioning and evaluation of WHISPAs. Participants were recruited through a national WHISPA network. Interviews were conducted between March and April 2024, transcribed verbatim and analysed using framework analysis informed by current guidance for evaluating complex interventions. Results Sixteen stakeholders participated. Five overarching themes were identified: support for evaluation; practical barriers to implementation and evaluation; outcomes for employers, employees and providers; workplace culture; and socio-economic inequalities. Participants supported mixed-methods evaluations and valued qualitative evidence alongside quantitative outcomes. Recruitment of employers and employees, particularly within small businesses and routine/manual occupations, was considered challenging. Standardised organisational outcomes, such as sickness absence and staff turnover, were viewed as important but difficult to measure consistently. Stakeholders highlighted workplace culture as a key determinant of intervention success and expressed concern that workplace health initiatives may inadvertently widen inequalities by preferentially engaging more advantaged organisations and workers. Conclusions Stakeholders considered evaluation of WHISPAs necessary but highlighted methodological and practical challenges. Future evaluations should use mixed-methods designs, equity-focused recruitment strategies, and account for organisational context and workplace culture. Developing robust evaluation frameworks is essential to strengthen the evidence base for workplace health interventions and support equitable implementation. These findings have informed the development of a new NIHR-funded workplace health evaluation, including outcome selection, evaluation methods and strategies to address equity and implementation challenges.