title: The formative development of an industry-specific, evidence-informed toolkit to improve the working conditions and health of UK contact centre advisors
Creators: name: Bell, Z
Publisher: name: Liverpool John Moores University
Year: 2025

description: Contact centre advisors are at risk of ill health due to poor working conditions and low pay. This contributes to excessive sickness absence and attrition in contact centre advisors. Approximately 812,000 advisors work within the UK’s 6000 contact centres, totalling 4% of the UK’s working population. Contact centres can put health initiatives in place which seek to improve advisor wellbeing. In line with the development phase of the Medical Research Council’s (MRC) Framework, the overarching aim of this thesis was to inform the development of an industry-specific, evidence-informed toolkit to improve the working conditions and health of UK contact centre advisors. Three studies were undertaken to achieve this aim. The study 1 scoping review aimed to investigate the volume, effectiveness, acceptability, and feasibility of health-promoting interventions for contact centre advisors. Searches conducted across four databases (MEDLINE, PsycInfo, CINAHL, Web of Science) and reference checking in February 2023 identified health-promoting interventions for contact centre advisors. Extracted and coded data from eligible interventions were systematically synthesised using the nine intervention functions of the Behaviour Change Wheel and behaviour change technique taxonomy. This scoping review identified a low number of high quality and peer-reviewed health-promoting intervention studies for contact centre advisors (28 studies since 2003). Most interventions were conducted in high-income countries with office-based advisors, predominantly using environmental restructuring and training strategies to improve health. Most interventions reported positive effectiveness results for the primary intended outcomes, which were broadly organised into: i) health behaviours (sedentary behaviour, physical activity, smoking); ii) physical health outcomes (musculoskeletal health, visual health, vocal health, sick building syndrome); iii) mental health outcomes (stress, job control, job satisfaction, wellbeing). Few interventions evaluated acceptability and feasibility. Study 2 aimed to explore factors affecting the adoption and implementation of contact centre health initiatives and how contact centres evaluate health initiatives. This two-phased mixed methods study explored health and wellbeing decision-makers’ perspectives on these processes in UK contact centres. Phase one: semi-structured interviews with 11 contact centre decision-makers explored factors influencing the adoption and implementation of health initiatives and the evaluation methods and outcomes considered important. Interviews were inductively coded using reflexive thematic analysis and mapped to behaviour change theory (COM-B and TDF). Phase two: 38 contact centre decision-makers completed a survey to assess consensus on phase one findings. Factors important to the adoption of health initiatives were leadership buy-in, listening to advisors, the availability of money and resources, and perceiving the need to support employees. Manager/team leader buy-in, time for leaders to prioritise health initiatives, having experienced leaders, and the flexibility to adapt health initiatives to 2 employee needs, were important for implementation. Centres used a variety of methods for evaluation, considering a range of outcomes. These original findings can inform guidance for contact centres that encourages the adoption, implementation and evaluation of health initiatives to improve advisor health. Study 3 used a two-phase mixed methods study to explore factors affecting advisors’ awareness and engagement with health initiatives, and which health initiatives are perceived to be effective for improving advisor health from decision-makers’ and advisors’ perspective. Phase one: semi-structured interviews and focus groups with 23 advisors and 11 health and wellbeing decision-makers. Data was coded inductively using reflexive thematic analysis and mapped to behaviour change theory (COM-B, TDF, BCW). Phase two: 116 advisors and 38 decision-makers across UK contact centres completed a survey to assess consensus on phase one findings for engagement and perceived effectiveness. Advisors had limited awareness of health initiatives, highlighting the need for improved communication. Factors important to advisors’ engagement with health initiatives included centres offering optional initiatives, with barriers including confidentiality concerns and limited access to health initiatives due to work demands, remote employment, and having a complex sign-up process. Fourteen health initiatives were deemed effective for improving advisor health, for six initiatives only advisors agreed on effectiveness, and five initiatives were not agreed to be effective. These findings underscore the need for tailored health initiatives that align with the unique working environments of contact centres and calls for improved communication strategies to improve awareness of initiatives, as well as fostering greater engagement among advisors. Overall, this thesis has produced original evidence and associated recommendations to inform the development of a toolkit to improve the health of UK contact centre advisors. Future research will seek to co-develop the toolkit, followed by feasibility and pilot testing in line with the MRC framework. This original research has clear potential for directly benefiting contact centre advisors by addressing their unique health challenges and improving working conditions.