Affinity Health at Work


Consultancy: Evidence-based health improvement strategy

Client: Transport for London (TfL)

Project aim:  To investigate how best TfL could support health-related behaviour change in its workforce – both choosing the best activities and implementing them in an effective way

What we did:

The project included reviewing evidence from four different sources:

1. The best available external research evidence – We conducted literature reviews of both the academic and practitioner literature to establish the latest findings from the health promotion, health improvement, public health and behaviour change literatures.

2. Practitioner expertise and judgement – We conducted a focus group with practitioners from relevant disciplines (OH, HR, H&S and wellbeing) from a range of organisations, as part of a master-class for the Affinity Health at Work research consortium, to gather their views and expertise on health promotion/improvement activities.

3. Evidence from the local context – We conducted interviews with 18 stakeholders from within TfL from the Occupational Health department, Health Improvement steering group and operational management to understand what was working well and why, what the facilitators and barriers had been and what they saw as priorities for future health improvement activities.

4. Perspectives of those who may be affected by the interventions – We conducted a questionnaire survey with employees and managers from within TfL to understand their views on priorities for health behaviour change, barriers and facilitators.

We brought all of the evidence together to draw conclusions and create a set of recommendations for TfL about where to focus their health improvement activities (healthy eating and physical activity came out at the priority areas), what to implement, and a process for implementing health improvement activities in the future. We also provided a checklist to help practitioners within TfL identify whether an intervention would work in their setting.



* Evidence based approach – By gathering a wide range of evidence, we helped ensure that TfL is looking at what the different types of evidence from within and outside TfL could provide to help steer their strategy around health improvement, both in terms of the activities they undertake and the way in which they implement them.

* Engagement – By gathering the views and input of internal stakeholders, employees and managers we helped engage the relevant people in terms of guiding and setting TfL’s health improvement direction. This groundwork of engagement will also provide a basis from which to engage key audiences in the implementation of health improvement activities.

* Clear feedback on what works – By looking at both the external research evidence and finding out about what had worked in the past within TfL, the project gave TfL a clear steer on what health improvement activities have been shown to be effective.

* Prioritisation – The feedback from internal stakeholders, managers and employees gives those working on health improvement projects clarity about the priority areas on which to focus future activities.

* Step by step process and checklist – The recommendations provided TfL with guidance on a step by step process for implementing health improvement activities and a checklist to support decision-making.


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