Improving employer and employee well-being in small and medium-sized enterprises in Flanders: a realist evaluation protocol of the FitBonus program

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BACKGROUND: High levels of absenteeism, presenteeism, and productivity loss are significant issues, especially for small and medium-sized enterprises (SMEs), which form a large part of the workforce in Flanders. The FitBonus program, commissioned by the Flemish Government, aims to improve the physical, mental, and social well-being of employers and employees in SMEs. This protocol outlines the methodology for a realist evaluation of the FitBonus program to understand how, why, for whom and under what circumstances the program enhances overall well-being and perceived workability among employers and employees in SMEs in Flanders. METHODS: The evaluation is conducted in three phases: Phase 1 involves developing an Initial Program Theory (IPT) through stakeholder consultations, program documentation review, and literature review. Phase 2 validates the IPT using a mix of quantitative data from online surveys and qualitative data from interviews and focus groups. Phase 3 refines the IPT based on the findings, resulting in a detailed theory and practical recommendations. DISCUSSION: This realist evaluation protocol aims to elucidate the mechanisms and contextual factors influencing the FitBonus program's potential success in improving physical, mental, and social well-being, as well as perceived workability. The insights gained from this evaluation will offer actionable recommendations for optimizing the program's implementation and effectiveness. Additionally, by enhancing the understanding of how well-being interventions work in various organizational contexts, this study can inform the development of future workplace well-being programs, leading to more targeted and effective interventions.

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