Effects of a Randomized Intervention to Improve Workplace Social Capital in Community Health Centers in China

Objective To examine whether workplace social capital improved after implementing a workplace social capital intervention in community health centers in China. Methods This study was conducted in 20 community health centers of similar size in Jinan of China during 2012–2013. Using the stratified site randomization, 10 centers were randomized into the intervention group; one center was excluded due to leadership change in final analyses. The baseline survey including 447 staff (response rate: 93.1%) was conducted in 2012, and followed by a six-month workplace social capital intervention, including team building courses for directors of community health centers, voluntarily public services, group psychological consultation, and outdoor training. The follow-up survey in July 2013 was responded to by 390 staff members (response rate: 86.9%). Workplace social capital was assessed with the translated and culturally adapted scale, divided into vertical and horizontal dimensions. The facility-level intervention effects were based on all baseline (n = 427) and follow-up (n = 377) respondents, except for Weibei respondents. We conducted a bivariate Difference-in-Difference analysis to estimate the facility-level intervention effects. Results No statistically significant intervention effects were observed at the center level; the intervention increased the facility-level workplace social capital, and its horizontal and vertical dimensions by 1.0 (p = 0.24), 0.4 (p = 0.46) and 0.8 (p = 0.16), respectively. Conclusions The comprehensive intervention seemed to slightly improve workplace social capital in community health centers of urban China at the center level. High attrition rate limits any causal interpretation of the results. Further studies are warranted to test these findings.研究目的：旨在探究中国社区卫生服务中心实施工作场所社会资本（workplace social capital）干预措施后，其工作场所社会资本是否得到提升。 研究方法：本研究于2012—2013年在中国济南市20家规模相近的社区卫生服务中心开展。采用分层场所随机化方法，将其中10家中心随机分配至干预组；最终分析阶段有1家中心因领导层变动被排除。研究于2012年开展基线调查，共纳入447名工作人员（应答率93.1%），随后实施为期6个月的工作场所社会资本干预项目，内容包括社区卫生服务中心管理者团队建设课程、志愿公共服务、团体心理咨询及户外拓展训练。2013年7月开展随访调查，共回收390份有效问卷（应答率86.9%）。工作场所社会资本采用经翻译与文化调适的量表进行测评，该量表分为垂直维度与水平维度。机构层面的干预效应分析基于基线（n=427）与随访（n=377）的全部受访者数据，排除潍北地区的受访者。本研究采用双变量双重差分分析对机构层面的干预效应进行估算。 研究结果：在机构层面未观察到具有统计学意义的干预效应；干预使机构层面的工作场所社会资本及其水平、垂直维度分别提升了1.0（p=0.24）、0.4（p=0.46）与0.8（p=0.16）。 研究结论：该综合性干预措施似乎可在机构层面轻度提升中国城市社区卫生服务中心的工作场所社会资本。较高的失访率限制了本研究结果的因果推断效力，未来仍需开展进一步研究以验证本次发现。