title: A multilevel model of organizational health culture and the effectiveness of health promotion.
abstract: OBJECTIVE
  Organizational health culture is a health-oriented core characteristic of the organization that is shared by all members. It is effective in regulating health-related behavior for employees and could therefore influence the effectiveness of health promotion efforts among organizations and employees. This study applied a multilevel analysis to verify the effects of organizational health culture on the organizational and individual effectiveness of health promotion.
  
  
  METHODS
  At the organizational level, we investigated the effect of organizational health culture on the organizational effectiveness of health promotion. At the individual level, we adopted a cross-level analysis to determine if organizational health culture affects employee effectiveness through the mediating effect of employee health behavior.
  
  
  METHODS
  The study setting consisted of the workplaces of various enterprises.
  
  
  METHODS
  We selected 54 enterprises in Taiwan and surveyed 20 full-time employees from each organization, for a total sample of 1011 employees.
  
  
  METHODS
  We developed the Organizational Health Culture Scale to measure employee perceptions and aggregated the individual data to formulate organization-level data. Organizational effectiveness of health promotion included four dimensions: planning effectiveness, production, outcome, and quality, which were measured by scale or objective indicators. The Health Promotion Lifestyle Scale was adopted for the measurement of health behavior. Employee effectiveness was measured subjectively in three dimensions: self-evaluated performance, altruism, and happiness.
  
  
  METHODS
  Following the calculation of descriptive statistics, hierarchical linear modeling (HLM) was used to test the multilevel hypotheses.
  
  
  RESULTS
  Organizational health culture had a significant effect on the planning effectiveness (β = .356, p < .05) and production (β = .359, p < .05) of health promotion. In addition, results of cross-level moderating effect analysis by HLM demonstrated that the effects of organizational health culture on three dimensions of employee effectiveness were completely mediated by health behavior.
  
  
  CONCLUSIONS
  The construct connections established in this multilevel model will help in the construction of health promotion theories. The findings remind business executives that organizational health culture and employee health behavior help improve employee effectiveness.
authors.forename: Yea-Wen
authors.initials: YW
authors.lastname: Lin
authors.forename: Yueh-Ysen
authors.initials: YY
authors.lastname: Lin
mesh_terms: D000328:Adult; D005260:Female; D015438:Health Behavior; D006293:Health Promotion / Q000379:methods; D006801:Humans; D008297:Male; D016272:Occupational Health; D015279:Organizational Culture; D015397:Program Evaluation; D011795:Surveys and Questionnaires; D013624:Taiwan; D017132:Workplace / Q000458:organization & administration / Q000523:psychology
keywords: Health Behavior; Health focus: fitness/physical activity, intellectual health, social health; Manuscript format: research; Multilevel Model; Organizational Effectiveness of Health Promotion; Organizational Health Culture; Outcome measure: productivity, absenteeism, other financial/economic; Prevention Research; Research purpose: modeling/relationship testing; Setting: workplace; Strategy: culture change; Study design: quantitative research; Target population age: adults; Target population circumstances: education/income level