Arsenic in plants

4.2.1 Study design

This qualitative cross-sectional study used focus groups and interviews to explore contact centre stakeholder perspectives. Questionnaires were completed after the focus group or interview to describe the sample. Qualitative findings are reported in line with the consolidated criteria for reporting qualitative research (COREQ) checklist (Tong, Sainsbury and Craig, 2007). Ethical approval was obtained from Liverpool John Moores research ethics committee (16/SPS/033).

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4.2.2 Participants and setting

A convenience sample of participants were recruited from four private contact centre companies with branches in the North West of England, situated in both urban (n=2) and rural (n=2) settings (Table 4.1). Two of the four centres implemented height-adjustable workstations and frequent break schedules as remedial measures for employees with musculoskeletal or chronic medical conditions, following a display screen equipment assessment (HSE, 2002). Each company expressed interest in the study following an invited presentation by the research team at a North West of England contact centre forum. After individual meetings to discuss the study aims and requirements, each company provided gatekeeper consent to recruit their employees and conduct the research in their centre. Call agents, team leaders and senior staff (consisting of human resources, head of centre, support team and engagement manager roles) received a recruitment message and participant information sheet, developed by the research team, via each company's internal e-mail system. Employees were eligible if they were ≥18 years old and ≥0.8 full time or part time equivalent worker in a call agent, team leader or senior staff role. All call agents operated in inbound call taking roles. Participants had 2 weeks to express interest by contacting the main author via email or an assigned contact within each centre. Interested and eligible participants (call agents n=20, team leaders n=11, senior staff n=12) provided written informed consent. There was no racial or gender bias in participant selection.

63 Table 4.1. Descriptive company information for the participating contact centres across the three empirical studies. Each company was located in the North West of England (within a 50-mile radius of the research institution) and was affiliated with the Call North West forum.

All companies handled inbound call taking and operated in large open plan office environments. Number of call agents n= <100 seats Location Wigan, UK

No height-adjustable workstations installed at the time of data collection Team leader ratio 1:14

Large ratio of agency to full time staff ~ 70:30 at the time of data collection.

Company 2 (Study 1)

Company: Private not-for-profit Industry: Social housing

Company size 201-500 employees Number of call agents n= ~16 seats Location Manchester UK

Mental health workplace champions in place on site.

No height-adjustable workstations installed at the time of data collection Team leader ratio 1:8 Number of call agents n= ~280 seats Location: Manchester UK

Rotational shift pattern working five 7.5 hour shifts a week between 8am and 9pm, 5 days out of 7- Monday – Sunday

Provided a number of height adjustable workstations for individuals with a pre-existing medical or musculoskeletal condition following a display screen and occupational health assessment. Number of call agents n= <100 seats Location: Warrington UK

Provided a number of height adjustable workstations for individuals with a pre-existing medical or musculoskeletal condition following a display screen and occupational health assessment.

Team leader ratio 1:10

4.2.3 Focus groups and interviews

Aligned to the pragmatic epistemology throughout this thesis, focus groups were used to elicit in-depth insights across the three key stakeholder groups within four contact centres.

Focus groups have similarly been used to explore employee and employer attitudes towards potential SB and PA intervention strategies (De Cocker et al., 2015), and employee perceptions of a SB workplace intervention (Chau et al., 2014). Compared to

64 quantitative methods such as surveys, focus groups can highlight attitudes and assumptions within a population, with participant interactions able to explore the extent to which perspectives are consistent and/or contrary (Robinson, 1999). The aim was to recruit a minimum of 4-8 participants per focus group, in line with previous recommendations (Kitzinger, 1995; Tong, Sainsbury and Craig, 2007). Due to the number of call agents who expressed interest, conflicting work schedules, and, staffing numbers for team leaders and senior staff, focus group size ranged between 2-6 participants, and three one-on-one interviews were conducted (two with team leaders and one with a senior staff member). Data collection took place on site at each company’s North West branch during working hours between July-October 2016. Accordingly, the first author who is experienced in qualitative research, conducted six semi-structured focus groups with call agents, two with team leaders and four with senior staff. To increase homogeneity, participants were grouped according to job role to reflect the hierarchical organisational structure (Shenton, 2004). A team leader was present during two call agent focus groups in company 3, however their contributions were considered important to the research objectives and did not appear to impact the agents willingness to openly discuss their perspectives and experiences (Kitzinger, 1995). To maintain participant confidentiality and safeguard participants and the researcher, data collection occurred in a meeting space familiar to all participants that could be overseen, but not overheard. All focus groups and interviews were recorded using a digital audio recorder and ranged from 29-87 minutes duration (mean 56 ± 14 min).

To enhance the credibility and trustworthiness of the data, the focus group schedule was developed in line with organisational, environmental, interpersonal and intrapersonal levels of the SEM (Bronfenbrenner, 1977; McLeroy et al., 1988), and grounded within current literature advocating a multi-level approach to workplace intervention development (Neuhaus et al., 2014c; Healy et al., 2016c). The protocol for delivering the focus groups and interviews was standardised, using the semi-structured schedule as a guide to promote a commonality throughout the focus groups. To allow participants to respond

65 openly and freely however, flexibility in the order and sequence of questions was permitted (Kitzinger, 1995). Questions addressed perceived factors influencing call agents workplace PA and SB. Within this, discussion areas included current working practices and initiatives that promote or negate SB and PA, perceived roles and responsibilities for promoting health and wellbeing, and employee perspectives on the current workplace recommendations (Buckley et al., 2015). The first author developed the focus group schedule, which was reviewed by two members of the research team (LG, RM) during team briefing sessions. No pilot interviews or focus groups were conducted prior to data collection, although consistent themes emerged across the 12 focus groups and 3 interviews, which suggests saturation was reached (Tong, Sainsbury and Craig, 2007).

4.2.4 Qualitative analysis

The method of qualitative analysis is described in detail in section 3.4.1. The SEM provided the point of departure framework for the deductive analysis. During the inductive process, transcriptions were read and re-read to familiarise the researcher with the complete data set, and initial codes were generated from a piece of text that related to factors influencing workplace SB and PA (Vaismoradi, Turunen and Bondas, 2013), prior to being imported into QSR NVivo software 10 package.

4.2.5 Survey and questionnaires

Participants descriptive demographic information and wellbeing reported as described in section 3.4.1.3. The International PA Questionnaire (IPAQ) (long form) assessed habitual PA over the previous 7-days (Booth et al., 2003). Twenty-seven questions assessed the frequency and duration of moderate and vigorous-intensity PA and walking activities undertaken across four domains (occupational, transport, household and recreation).

Total PA scores were calculated through summation of duration and frequency of each activity across each domain, and classified as low (<600 MET min/week), moderate

(600-66 2999 MET min/week) or high activity (≥3000 MET min/week). Estimated weekend and weekday sitting time values are not included in total PA score. Previous studies have shown good test-retest reliability (0.8), with fair-moderate criterion validity between IPAQ and accelerometer data (0.33, 95% CI 0.26-0.39) (Booth et al., 2003).

The Workforce Sitting Questionnaire assessed previous 7-day workday and non-workday sitting during travel, work, watching TV, using a computer (at home) and during other leisure activities (Chau et al., 2011). Total sitting time for a typical workday and non-workday were calculated by summing sitting times across each domain. Participants reported the number of workdays during the previous 7-days, which allowed a weighted mean for total sitting time per day to be calculated. The questionnaire has good-to-excellent test-retest reliability (0.65-0.80) (Chau et al., 2011).