Working from home during COVID-19: boundary management tactics and energy resources management strategies reported by public service employees in a qualitative study.

BACKGROUND: Increased working from home has imposed new challenges on public service employees, while also granting opportunities for job crafting. Grounding on the Job Demands-Resources model and Hobfoll's Conservation of Resources theory this exploratory research aims to investigate the work-nonwork balance of employees one and a half years after the outbreak of the COVID-19 pandemic. Therefore, the research focus lies on employees' job crafting strategies to optimize their working from home experience concerning boundary management and energy resource management. METHODS: Twelve semi-structured telephone interviews were conducted with public service employees from different sectors in Germany. The experiences were content analyzed using the software MaxQDA and inductive and deductive categories were derived. RESULTS: Boundary management comprised different strategies such as communicative (e.g., negotiating work time), physical (e.g., going to the garden), temporal (e.g., logging off in between the work day) and behavioral (e.g., prioritizing tasks) strategies. The job crafting strategies regarding energy management included preventing exhaustion (e.g. taking breaks), healthy cooking and energy management in case of sickness (e.g. deciding on sick leave). CONCLUSIONS: This qualitative case study enriches research on job crafting by offering insights on boundary tactics and energy resources management strategies for remote working during the COVID-19 pandemic. The results point out different starting points for employees and decision makers, how a work-nonwork balance, energy management and thus employees' wellbeing may be increased when working from home in the future. TRIAL REGISTRATION: The study design and methodology were approved by the Ethics Committee of the University of Cologne and the study was prospectively registered (Ref No. 21-1417_1).

Work-life boundary management of peer support workers when engaging in virtual mental health support during the COVID-19 pandemic: a qualitative case study.

BACKGROUND: Mental health care needs have increased since the COVID-19 pandemic was declared. Peer support workers (PSWs) and the organizations that employ them have strived to provide services to meet increasing needs. During pandemic lockdowns in Ontario, Canada, these services moved online and were provided by PSWs from their homes. There is paucity of research that examines how providing mental health support by employees working from home influences their work-life boundaries. This research closes the gap by examining experiences of work-life boundary challenges and boundary management strategies of PSWs. METHODS: A qualitative case study approach was adopted. Interviews with PSWs who held formal, paid positions in a peer support organization were conducted. Data was analyzed thematically using both inductive and deductive approaches. Descriptive coding that closely utilized participants' words was followed by inferential coding that grouped related themes into conceptual categories informed by boundary theory. Member checking was conducted. RESULTS: PSWs provided accounts of work-life boundary challenges that we grouped into three categories: temporal (work schedule encroachments, continuous online presence), physical (minimal workspace segregation, co-presence of household members and pets) and task-related (intersecting work-home activities). Strategies used by PSWs to manage the boundaries consisted of segmenting the work-life domains by creating separate timescapes, spaces and tasks; and integrating domains by allowing some permeability between the areas of work and life. CONCLUSION: The findings from this study can help inform management, practices, future research and policy on health care workforce. The study highlights the need to attend to the consequences of greater work-life integration for mental health workers since their successful practice is largely dependent on maintaining self-care. Training regarding work-life boundary management is highlighted as one of the ways to approach situations where work from home is required.

Work-family boundary management profiles and well-being at work: A study with militaries on a humanitarian aid mission.

This study aims to contribute to an analysis of the well-being of military personnel who are deployed on humanitarian aid missions, taking their work-family (personal life) boundary management into consideration by analyzing the relationship between their preferences and enacted boundaries and military personnel' well-being. Specifically, this study analyzed the boundary fit approach, positing that it is the adjustment between individuals' preferences and enacted boundaries that influences their well-being. Using a sample of 327 military personnel, boundary management profiles were performed, considering the fit between their segmentation preferences and enactment. Furthermore, the relationship between these profiles and the military personnel' well-being was established. The results indicated that misfit profiles were found where the soldiers enacted less segmentation than desired or, on the contrary, more integration than desired, and a profile with a fit between the work-family segmentation they desired and enacted. The military personnel in the fit profile had significantly higher levels of well-being (i.e.,less exhaustion and more work engagement) than those in the misfit profile, who enacted less segmentation than desired. The findings have implications for the design of boundary management literature and future military missions.

Our business, not the robot's: family conversations about privacy with social robots in the home.

The targeted use of social robots for the family demands a better understanding of multiple stakeholders' privacy concerns, including those of parents and children. Through a co-learning workshop which introduced families to the functions and hypothetical use of social robots in the home, we present preliminary evidence from 6 families that exhibits how parents and children have different comfort levels with robots collecting and sharing information across different use contexts. Conversations and booklet answers reveal that parents adopted their child's decision in scenarios where they expect children to have more agency, such as in cases of homework completion or cleaning up toys, and when children proposed what their parents found to be acceptable reasoning for their decisions. Families expressed relief when they shared the same reasoning when coming to conclusive decisions, signifying an agreement of boundary management between the robot and the family. In cases where parents and children did not agree, they rejected a binary, either-or decision and opted for a third type of response, reflecting skepticism, uncertainty and/or compromise. Our work highlights the benefits of involving parents and children in child- and family-centered research, including parental abilities to provide cognitive scaffolding and personalize hypothetical scenarios for their children.

The concept of "Work-Life-Blending": a systematic review.

Work-Life Blending refers to the permeability and dissolution of boundaries between work and personal life, bringing these domains closer together. However, a comprehensive, holistic definition or conceptualisation of Work-Life-Blending is currently lacking. This research aims to address this gap by conducting a systematic literature review to define and clarify the concept. The primary objective is to identify the key factors and dimensions of Work-Life-Blending by reviewing the current state of research, and by offering a clear and precise conceptual framework to guide further research in developing measurable and concrete concepts. We conducted a systematic review following the PRISMA guidelines to achieve this, drawing on keyword-based searches. We searched for English or German manuscripts in the electronic databases Business Source Premier and PsycARTICLES, using keywords such as "blending," "blurring," "fusion," "Entgrenzung," "Verschmelzung," "Vermischung," "boundary," "border," or "demarcation" in combination with "work" and "life." From 1,400 screened references between 2000 and 2023, we identified 302 eligible articles. After applying exclusion criteria, 51 records were retained. Employing a holistic approach, we developed a coding scheme to analyse the articles focusing on antecedents, processes, and outcomes of Work-Life-Blending. Articles were prioritized based on their impact, relevance, and data content. Our analysis revealed a diverse field, and we adopted Clark's central concepts (2000) to categorize Work-Life Blending into four key areas: Domains, Borders, Individual, and Interindividual. Structural analysis allowed us to gain deeper insights into the multifaceted nature of the research field. Diversification was evident in studies exploring various aspects, such as the combination of dimensions (e.g., organizational and individual factors), correlations between factors (e.g., working conditions), and the introduction of new constructs (e.g., motivational processes). Our research addresses a significant knowledge gap in the field of Work-Life-Blending, making valuable contributions to the existing body of knowledge. By examining key categories and proposing an extended definition, this study provides a robust foundation for further investigations. As a result, we established a classification of the determinants. Given the high degree of diversification, we offer a comprehensive framework for future research, contributing to a deeper understanding of Work-Life Blending.

Effects of strain on boundary management: findings from a daily diary study and an experimental vignette study.

Introduction: Transformations in the work-nonwork interface highlight the importance of effectively managing the boundaries between life domains. However, do the ways individuals manage the boundaries between work and nonwork life change from one day to the next? If so, which antecedents may explain these intra-individual fluctuations in boundary management? Drawing on boundary management, spillover, and resource theories, we investigate daily changes in segmentation preferences and integration enactments as a function of experiencing strain in work and nonwork life. Assuming that changes in segmentation preferences reflect an individual's strategy to regulate negative cross-role spillover, we suppose that strain increases individuals' segmentation preferences; at the same time, however, it could force individuals to enact more integration. Methods: We test our assumptions with data from two studies with different methodological approaches. The first study uses a daily diary research design (Study 1, 425 participants with 3,238 daily observations) in which full-time professionals rated strain in work and nonwork life, segmentation preferences, and integration enactments every evening for 10 workdays. The second study uses an experimental vignette research design (Study 2, 181 participants), where we experimentally manipulated strain in work and nonwork life and investigated causal effects on participants' hypothetical segmentation preferences. Results: The results of multilevel modeling analyses in Study 1 show that segmentation preferences and integration enactments fluctuate from day to day as a function of strain. More specifically, strain is related to preferring more segmentation but enacting more integration. Study 2 replicates the results of Study 1, showing that strain causally affects segmentation preferences. Discussion: This two-study paper is one of the first to address daily fluctuations in segmentation preferences and integration enactments, extending our knowledge of temporal dynamics in boundary management. Furthermore, it demonstrates that strain is an antecedent of these daily fluctuations, offering starting points for practical interventions.

Students managing work and study role boundaries: a person-centred approach.

To cope with demands of working while studying, students must structure the boundaries between these roles (e.g., integrate or segment them) to suit their preferences and circumstances. However, students differ on how well they do this, and we do not yet understand the factors that contribute to managing work and study well. We sought to determine if different student groups existed and if the groups reported different work, study, and wellbeing outcomes. Using latent profile analysis and assessing work-study boundary congruence and flexibility (N = 808; 76% female; MAge 19.6 years), we identified four groups of (a) "balanced" (65.4%; with moderate boundary congruence and flexibility); (b) "high work congruence and flexibility" (17.5%; working arrangements supportive of study role); (c) "low work congruence and flexibility" (9.7%; unsupportive workplace arrangements); and (d) "low study congruence" (7.3%; study arrangements unsupportive of work role). These groups reported different work/study demands, role conflict, study burnout, and perceived employability, with "balanced" and "high work congruence and flexibility" groups scoring more positively and "low work congruence and flexibility" and "low study congruence" groups scoring more negatively. Results supported that different student groups existed, and these will need different supports to manage their multiple role responsibilities.

Associations between the implementation of telework strategies and job performance: Moderating influences of boundary management preferences and telework experience.

Boosted by the COVID-19 pandemic, more than ever, an organization's success depends on its teleworkers' performance. However, little attention has been paid to the individual strategies implemented by teleworkers to achieve goals such as drawing boundaries between work- and private-life, working task-oriented and productively, and keeping social contact. We collected quantitative survey data of 548 teleworkers indicating their implementation of 85 telework strategies derived from scientific literature and popular media (e.g., working in a separate room, wearing work clothes at home), self-reported job performance, boundary management preferences, and telework experience. We identified (a) the implementation of telework strategies, (b) associations with job performance, (c) divergences between the implementation and the performance association, and (d) moderating influences of boundary management preferences and telework experience. The results suggest that the most implemented telework strategies tend to be the ones most positively associated with job performance. These telework strategies serve goals related to working task-oriented and productively by adopting a conducive work attitude as well as keeping social contact by using modern communication technology rather than goals related to drawing boundaries between work- and private-life. The findings underscore the benefits of expanding a narrow focus on telework strategies stemming from boundary theory to unravel telework strategies' puzzling impacts on (tele-) work outcomes. Also, taking a person-environment fit perspective appeared to be a promising approach to tailor evidence-based best practice telework strategies to teleworkers' individual preferences and needs (boundary management preferences and telework experience).

Who moved my boundary? Strategies adopted by families working from home.

With the increase of remote work after the COVID-19 pandemic, it can be expected that soon a great number of households will consist of more than one teleworker. This raises the question of how to manage work and nonwork boundaries for the collective of household members who work from home. To better understand the adjustment to collective work from home, we examined the experiences of 28 dual-income households with school-age children residing in five countries. In doing so, we found specific strategies that families used to manage boundaries between two or more household members' work, learning, and home domains. We identified four strategies to define boundaries in the collective (i.e., repurposing the home space, revisiting family members' responsibilities, aligning family members' schedules, and distributing technology access and use) and five strategies to apply boundaries to accommodate the collective (i.e., designating an informal boundary governor, maintaining live boundary agreements, increasing family communication, incentivizing/punishing boundary respect/violation, and outsourcing). Our findings have theoretical and practical implications for remote work and boundary management.

Privacy Attitudes and COVID Symptom Tracking Apps: Understanding Active Boundary Management by Users.

Multiple symptom tracking applications (apps) were created during the early phase of the COVID-19 pandemic. While they provided crowdsourced information about the state of the pandemic in a scalable manner, they also posed significant privacy risks for individuals. The present study investigates the interplay between individual privacy attitudes and the adoption of symptom tracking apps. Using the communication privacy theory as a framework, it studies how users' privacy attitudes changed during the public health emergency compared to the pre-COVID times. Based on focus-group interviews (N=21), this paper reports significant changes in users' privacy attitudes toward such apps. Research participants shared various reasons for both increased acceptability (e.g., disease uncertainty, public good) and decreased acceptability (e.g., reduced utility due to changed lifestyle) during COVID. The results of this study can assist health informatics researchers and policy designers in creating more socially acceptable health apps in the future.

Switching Gears: A Self-Regulatory Approach and Measure of Nonwork Role Re-Engagement Following After-Hours Work Intrusions.

As employees' personal lives are increasingly splintered by work demands, the boundary between work and nonwork domains is becoming ever more blurred. Grounded within a self-regulatory approach and the executive control function of inhibitory control, we operationalize and examine nonwork role re-engagement (NWRR)-the extent to which individuals can redirect attentional resources back to nonwork tasks following work-related intrusions. In phases 1 and 2, we develop and refine a psychometrically sound unidimensional measure for NWRR aligned with the self-regulatory processes of self-control and interference control underlying inhibitory control. In phase 3, we confirm the factor structure with a new sample. In phase 4 we validate the measure using the samples from phases 2 and 3 to provide evidence of criterion-related, convergent, and discriminant validity. NWRR was related to important well-being and work-related outcomes above and beyond existing self-regulatory and boundary management constructs. We offer theoretical and practical implications and an agenda to guide future research, as attentional agility becomes increasingly relevant in a home life replete with interruptions from work.

Remote workers' free associations with working from home during the COVID-19 pandemic in Austria: The interaction between children and gender.

Empirical evidence from the COVID-19 pandemic shows that women carried the major burden of additional housework in families. In a mixed-methods study, we investigate female and male remote workers' experiences of working from home (WFH) during the pandemic. We used the free association technique to uncover remote workers' representations about WFH (i.e., workers' reflection of subjective experiences). Based on a sample of 283 Austrian remote workers cohabitating with their intimate partners our findings revealed that in line with traditional social roles, men and women in parent roles are likely to experience WFH differently: Mothers' representations about WFH emphasize perceived incompatibility between the work and non-work sphere whereas fathers' representations highlight work-family facilitation of WFH. However, gender differences were also prevalent for women and men without children: Women seem to particularly benefit from more concentration at home, whereas men consider WFH as more efficient, practical and leading to less work. Thus, our findings imply that gender affected perceptions of WFH during the pandemic independently from children, but children seemed to increase the existing burden, in particular for women. To conclude, WFH can generally be seen as an enabler to reduce work-life/family conflict for both women and men, but bears different challenges based on the contextual (family) situation.

Employee Reactions to Interruptions from Family during Work.

In contemporary workplaces, spouses, parents, and children are frequently able to reach employees through telephone, text, or email. Although some employees may welcome this level of accessibility to their families, others may react negatively, but we know little about the individual differences or situational characteristics that relate to these reactions. To examine these reactions, we recruited samples of US residents, employed outside the home in a variety of occupations, who reported that they were recently interrupted at work by a family member. We measured four reactions to the episode (anger, sadness, complaining about the interruption, and the degree to which the employee forgave the family member). Results showed reactions related to interactions between two features of the interruption (the importance of the interruption and the severity of the disruption to one's work) and the employee's preference for integrating family and work roles.

Predicting Work-Life Conflict: Types and Levels of Enacted and Preferred Work-Nonwork Boundary (In)Congruence and Perceived Boundary Control.

In 2020, everyday life changed dramatically for employees worldwide as a result of the outbreak of the Covid-19 pandemic, where an estimated 558 million employees started working from home. The pandemic, therefore, marks a fundamental shift of individuals' work-nonwork boundaries, which can impact work-life conflict. In particular, the interplay between individuals' enacted boundaries (degree to which they separate/segment or blend/integrate work-nonwork), preferred boundaries (degree of preferred segmentation or integration of work-nonwork), and perceived control over work-nonwork boundaries, may relate to work-life conflict. This study, the first to the best of our knowledge, examines whether different types and levels of work-nonwork boundary (in)congruence matter for work-life conflict, and whether perceived boundary control moderates these relationships. Boundary (in)congruence represents the degree of (mis)fit between enacted and preferred segmentation or integration. Several types of (in)congruence are distinguished: "segmentation congruence" (enacting and preferring segmentation); "integration congruence" (enacting and preferring integration); "intrusion" (enacting integration but preferring segmentation) and "distance" (enacting segmentation but preferring integration). Data from 1,229 managers working in public and private organizations in Sweden was analyzed using polynomial regression analysis with response surface modeling and moderation analysis in SPSS Process. Findings showed that "integration congruence" was related with higher work-life conflict than "segmentation congruence." Moreover, a U-shaped relationship between incongruence and work-life conflict was found: the more incongruence, the more work-life conflict. Specifically, "intrusion" was related to higher work-life conflict than "distance." Finally, boundary control mitigated the effect of incongruence (especially "intrusion") on work-life conflict. From our findings, we may conclude that work-life conflict is impacted differently depending on the type and level of boundary (in)congruence. Particularly enacted and/or preferred integration may be problematic when it comes to work-life conflict, rather than just (in)congruence per se. Moreover, boundary control can be viewed as a key factor in combating work-life conflict, especially among individuals who enact integration, but prefer segmentation. Taken together, our study contributes new and substantial knowledge by showing the importance for research and HRM-policies that take into account different types and levels of boundary (in)congruence, as these are associated with different levels of work-life conflict, which, in turn, are moderated by boundary control.

The Bright and Dark Sides of Resources for Cross-Role Interrupting Behaviors and Work-Family Conflict: Preliminary Multigroup Findings on Remote and Traditional Working.

Using boundary management and conservation of resources theories, we examined how job resources (i.e., job autonomy and goal-oriented leadership) and a work-related personal resource (i.e., personal initiative at work) relate to cross-role interrupting behaviors-i.e., interrupting the work (or non-work) role to attend to competing non-work (or work) demands-and how, in turn, they correlate with work-family conflict. Furthermore, we examined differences in the proposed nomological network between workers adopting traditional and remote ways of working. Using a multigroup structural equation modelling approach on a sample of 968 employees from an Italian telecommunications company, we found that: (a) job autonomy was positively related to both work interrupting non-work behaviors and to non-work interrupting work behaviors, (b) goal-oriented leadership was negatively related to non-work interrupting work behaviors, (c) personal initiative at work was positively related to work interrupting non-work behaviors and, finally, (d) cross-role interrupting behaviors were positively related to work-family conflict. Additionally, our findings revealed previously undocumented results; (a) mediating patterns in how resources relate, through cross-role interrupting behaviors, to work-family conflict and (b) non-invariant associations among job autonomy, cross-role interrupting behaviors and work-family conflict across traditional and remote workers. The limitations and theoretical and practical implications of the present study are discussed.

Towards sustainable local welfare systems: The effects of functional heterogeneity and team autonomy on team processes in Dutch neighbourhood teams.

Nowadays, many European countries delegate health and social care responsibilities from the national level to local authorities. In January 2015, the Netherlands similarly introduced a policy programme authorising municipalities to set their own social welfare policy. A specific feature of this programme is that it stimulates municipalities to implement teams wherein professionals from different disciplines are collectively responsible for a team's decision-making. This suggests that teams ideally have (a) high levels of functional heterogeneity (professionals from different disciplines) and (b) high levels of team autonomy (collective responsibility and decision-making). Based on the policy programme, it can be further assumed that (a) information elaboration, (b) boundary management and (c) team cohesion in teams will improve. In practice, the majority (87%) of Dutch municipalities implemented neighbourhood teams in January 2015. A common feature of these neighbourhood teams is that the various professionals are collectively responsible for all the curative and preventive healthcare, social work and voluntary social support of the citizens in a specific neighbourhood. Nevertheless, the structure and organisation of neighbourhood teams (including the level of functional heterogeneity and team autonomy) vary within and between municipalities. Given this situation, our aim was to examine to what extent functional heterogeneity and team autonomy influence information elaboration, boundary management and team cohesion in neighbourhood teams. We developed six hypotheses based on literature that were then tested on data collected (between May 2016 and January 2017) through an online survey from 1335 professionals in 170 neighbourhood teams. An SEM analysis showed a positive effect of team autonomy on information elaboration, boundary management and team cohesion. Results further showed a negative effect of functional heterogeneity on information elaboration and boundary management. The implications of these findings for practitioners and academics are discussed.

Getting the Work-Nonwork Interface You Are Looking for: The Relevance of Work-Nonwork Boundary Management Fit.

Recently, work-family scholars have empirically demonstrated the importance of congruence between employees' boundary management preferences and boundary management supplies provided by the work environment in relation to employee attitudes and behavior. However, a theoretically grounded construct that captures this congruence is lacking. The present study addresses this gap by developing the construct and measure of work-nonwork boundary management fit, based on the needs-supplies fit framework. We cross-validate the scale in three independent samples (n = 188, diverse group of employees, n = 75, employees from one hospital, and n = 81, employees from one car company) and in a fourth sample (n = 458, working parents), we demonstrated the importance of work-nonwork boundary management fit for employee well-being (i.e., stress and work-life conflict). In particular, we confirmed its unique role in predicting employee well-being, above and beyond workload and work interrupting nonwork behaviors. Hence, we argue for considering work-nonwork boundary management fit when studying how work-family policies and organizational culture affect employees in the workplace.

Boundary Management Permeability and Relationship Satisfaction in Dual-Earner Couples: The Asymmetrical Gender Effect.

Given the increasing use of technology and the growing blurring of the boundaries between the work and nonwork domains, decisions about when to interrupt work for family and vice versa can have critical implications for relationship satisfaction within dual-earner couples. Using a sample of 104 dual-earner couples wherein one of the partners is a member of the largest Italian smartphone-user community, this study examines how variation in boundary management permeability within dual-earner couples relates to partner relationship satisfaction, and whether the effect differed by gender and partners' agreement on caregiving roles in the family. Using actor-partner analysis, we examined the degree to which an individual and his or her partner's level of family-interrupting work behaviors (FIWB, e.g., taking a call from the partner while at work) and work-interrupting family behaviors (WIFB, e.g., checking work emails during family dinner) was positively related to relationship satisfaction. Results show that women experienced greater relationship satisfaction than men when their partners engaged in higher levels of FIWB, and this relationship was stronger when partners had perceptual congruence on who is primarily responsible for caregiving arrangements in the family. This study advances research on dual-earner couples by showing the importance of examining boundary management permeability as a family social phenomenon capturing transforming gender roles.

Patient-centered boundary mechanisms to foster intercultural partnerships in health care: a case study in Guatemala.

BACKGROUND: Up to one half of the population in Africa, Asia and Latin America has little access to high-quality biomedical services and relies on traditional health systems. Medical pluralism is thus in many developing countries the rule rather than the exception, which is why the World Health Organization is calling for intercultural partnerships to improve health care in these regions. They are, however, challenging due to disparate knowledge systems and lack of trust that hamper understanding and collaboration. We developed a collaborative, patient-centered boundary mechanism to overcome these challenges and to foster intercultural partnerships in health care. To assess its impact on the quality of intercultural patient care in a medically pluralistic developing country, we conducted and evaluated a case study. METHODS: The case study took place in Guatemala, since previous efforts to initiate intercultural medical partnerships in this country were hampered by intense historical and societal conflicts. It was designed by a team from ETH Zurich's Transdisciplinarity Lab, the National Cancer Institute of Guatemala, two traditional Councils of Elders and 25 Mayan healers from the Kaqchikel and Q'eqchi' linguistic groups. It was implemented from January 2014 to July 2015. Scientists and traditional political authorities collaborated to facilitate workshops, comparative diagnoses and patient referrals, which were conducted jointly by biomedical and traditional practitioners. The traditional medical practices were thoroughly documented, as were the health-seeking pathways of patients, and the overall impact was evaluated. RESULTS: The boundary mechanism was successful in discerning barriers of access for indigenous patients in the biomedical health system, and in building trust between doctors and healers. Learning outcomes included a reduction of stereotypical attitudes towards traditional healers, improved biomedical procedures due to enhanced self-reflection of doctors, and improved traditional health care due to refined diagnoses and adapted treatment strategies. In individual cases, the beneficial effects of traditional treatments were remarkable, and the doctors continued to collaborate with healers after the study was completed. Comparison of the two linguistic groups illustrated that the outcomes are highly context-dependent. CONCLUSIONS: If well adapted to local context, patient-centered boundary mechanisms can enable intercultural partnerships by creating access, building trust and fostering mutual learning, even in circumstances as complex as those in Guatemala. Creating multilateral patient-centered boundary mechanisms is thus a promising approach to improve health care in medically pluralistic developing countries.

Translating evidence into healthcare policy and practice: Single versus multi-faceted implementation strategies - is there a simple answer to a complex question?

How best to achieve the translation of research evidence into routine policy and practice remains an enduring challenge in health systems across the world. The complexities associated with changing behaviour at an individual, team, organizational and system level have led many academics to conclude that tailored, multi-faceted strategies provide the most effective approach to knowledge translation. However, a recent overview of systematic reviews questions this position and sheds doubt as to whether multi-faceted strategies are any better than single ones. In this paper, we argue that this either-or distinction is too simplistic and fails to recognize the complexity that is inherent in knowledge translation. Drawing on organizational theory relating to boundaries and boundary management, we illustrate the need for translational strategies that take account of the type of knowledge to be implemented, the context of implementation and the people and processes involved.