title: Effects of a randomized intervention to improve workplace social capital in community health centers in China.
abstract: OBJECTIVE
  To examine whether workplace social capital improved after implementing a workplace social capital intervention in community health centers in China.
  
  
  METHODS
  This study was conducted in 20 community health centers of similar size in Jinan of China during 2012-2013. Using the stratified site randomization, 10 centers were randomized into the intervention group; one center was excluded due to leadership change in final analyses. The baseline survey including 447 staff (response rate: 93.1%) was conducted in 2012, and followed by a six-month workplace social capital intervention, including team building courses for directors of community health centers, voluntarily public services, group psychological consultation, and outdoor training. The follow-up survey in July 2013 was responded to by 390 staff members (response rate: 86.9%). Workplace social capital was assessed with the translated and culturally adapted scale, divided into vertical and horizontal dimensions. The facility-level intervention effects were based on all baseline (n = 427) and follow-up (n = 377) respondents, except for Weibei respondents. We conducted a bivariate Difference-in-Difference analysis to estimate the facility-level intervention effects.
  
  
  RESULTS
  No statistically significant intervention effects were observed at the center level; the intervention increased the facility-level workplace social capital, and its horizontal and vertical dimensions by 1.0 (p = 0.24), 0.4 (p = 0.46) and 0.8 (p = 0.16), respectively.
  
  
  CONCLUSIONS
  The comprehensive intervention seemed to slightly improve workplace social capital in community health centers of urban China at the center level. High attrition rate limits any causal interpretation of the results. Further studies are warranted to test these findings.
authors.affiliation: Center for Health Management and Policy of Shandong University (key Lab of Health Economics and Policy, National Health and Planning Commission), Jinan, Shandong, China.
authors.forename: Xiaojie
authors.initials: X
authors.lastname: Sun
authors.affiliation: Center for Health Management and Policy of Shandong University (key Lab of Health Economics and Policy, National Health and Planning Commission), Jinan, Shandong, China.
authors.forename: Nan
authors.initials: N
authors.lastname: Zhang
authors.affiliation: Center for Health Management and Policy of Shandong University (key Lab of Health Economics and Policy, National Health and Planning Commission), Jinan, Shandong, China.
authors.forename: Kun
authors.initials: K
authors.lastname: Liu
authors.affiliation: Health Bureau of Jinan, Jinan, Shandong, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Li
authors.affiliation: Finnish Institute of Occupational Health, Helsinki, Finland.
authors.forename: Tuula
authors.initials: T
authors.lastname: Oksanen
authors.affiliation: Department of Global Health Systems and Development, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, United States of America.
authors.forename: Lizheng
authors.initials: L
authors.lastname: Shi
mesh_terms: D002681:China; D003151:Community Health Centers / Q000191:economics; D006801:Humans; D066270:Social Capital; D011795:Surveys and Questionnaires; D000078329:Workforce; D017132:Workplace / Q000191:economics