Discussion
depression, anxiety
Regarding our first research question, a positive change in mental wellbeing, symptoms of anxiety and personal stigma towards depression and anxiety was found. These findings support frameworks that postulated that workplace interventions directed at both the individual and organisational level have a positive impact on mental wellbeing (Martin et al. Nevertheless, no significant effects were observed for burnout, symptoms of depression and productivity losses in terms of absenteeism and presenteeism. The absence of significant effects here may have various reasons. In general terms, the implementation context of the pilot study was not ideal, as it was conducted during the height of the COVID-19 pandemic, which impacted considerably on the implementation process. Communications with the SMEs occurred mostly online and many employees worked from home during that period. More specifically for burnout, it is possible that the 6-month implementation period was too short to induce improvements during the pandemic (Ghahramani et al. Based on the pilot results, we have no reason to question the inclusion of any of the selected outcomes specified in our ToC. For some of the outcomes, we do have doubts on whether we selected the most appropriate indicator for our study especially for the outcomes ‘burnout’ and ‘productivity losses’. Ahead of the large-scale study, we propose a modified operationalization for both. The OLBI questionnaire, which we used to measure burnout, has been criticized by researchers in the past as it assesses disengagement and exhaustion using not only negatively but also positively worded items. Positively worded questions may be more suited to capture work-engagement rather than burnout (Schaufeli and De Witte Productivity losses, as measured with the SPS-6 and the WPAI-GH, showed neither improvement of absenteeism nor improvement of presenteeism at follow-up. As it is presented in Table For depression, it is of importance that the scores of participants on the PHQ-9 were already very low at baseline leaving little room for improvement. The PHQ-9 is a valid scale to assess the efficacy of interventions targeting depression (Oehler et al. With respect to the second and third research questions concerning differences in the long-term outcomes between the involved work sectors and leadership roles, we did not find significant differences in the long-term outcomes between them. We consider this to be a positive result as we developed a tailored intervention that would be able to address the different needs of people coming from three work sectors and having low or high leadership roles within the organisations.