Recovery in a digitalized world : An inductive qualitative case study on employers’ and employees’ perceptions of digital solutions to promote recovery

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Recovery in a

digitalized world

- An inductive qualitative case study on

employers’ and employees’ perceptions of

digital solutions to promote recovery

KURS:Examensarbete i företagsekonomi, 15 hp

PROGRAM: Human Resources

FÖRFATTARE: Jessica Hillyer, Maria Liljeqvist

EXAMINATOR: Ulf Larsson-Olaison

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Preface

This thesis was written in the spring semester of 2020 in support of our bachelor’s degree in Business Administration with an orientation towards Human Resources at the School of Education and Communication, Jönköping University.

For starters, we would like to thank all research participants for your time and dedication. Without your participation, we would not have been able to complete this research. Thanks to your answers, we have been able to collect enough data to understand our research phenomenon and to answer our research purpose.

Next, we would like to thank the members of our seminar group and our opponents at the final seminar. We appreciate the time you have taken to read our thesis and the feedback you have provided us with. Your suggestions for changes and improvements have been valuable when developing our theses into a final draft.

Finally, we would like to thank our thesis supervisor, Jean-Charles E. Languilarie. You have not only given us your valuable time but also provided us with valuable insights during these past ten weeks. Without your support and help, we would not have been able to complete our thesis. We appreciate your full commitment and engagement and the time and efforts you have spent on both reading our thesis and guiding us through this process.

A big thanks to everyone involved.

Jönköping, May 8, 2020.

_______________________ ________________________ Jessica Johansson Hillyer Maria Liljeqvist

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JÖNKÖPING UNIVERSITY School of education and communication Bachelor Thesis, 15 hp in Business Administration HR-program Spring 2020

SUMMARY

Jessica Johansson Hillyer, Maria Liljeqvist

Recovery in a digitalized world

An inductive qualitative case study on employers’ and employees’ perceptions of digital solutions to promote recovery

Number of pages: 50

Recovery from work is crucial for health and well-being, and organizations have an obligation to enable employee recovery. Organizations can promote employee recovery by implementing strategies and thus reach sustainable development. In 2020, organizations exist in a digitalized world, which has expedited the need to implement digital solutions and use them for processes. Encouraging and fostering recovery are central elements in promoting recovery and digital solutions could help with both elements.

The usage of digital solutions include how digital solutions are used and how they could be used. There is no previous research on digital solutions, recovery promotion and usage, so we define our research phenomenon as the usage of digital solutions to promote recovery. We identify our research gap in the connection of recovery and digital solutions in an organizational context. By describing the research phenomenon, we can fill this research gap and thus add to the existing literature on organizational health and well-being. The purpose of this research is to describe organizations’ usage of digital solutions to promote recovery.

By performing an inductive qualitative case study, we collect data by performing a documentation review and online surveys. We find that mobile applications, virtual assistants, activity trackers, virtual reality and smart electric bicycles can be used to promote recovery. We also find a favorable context for both recovery and for digital solutions to promote recovery. Further, we see potential for using the identified digital solutions to promote recovery. We conclude that strategy implementation consisting of digital solutions to promote recovery in organizations will lead to a higher level of healthy workforce.

Keywords: recovery, promoting recovery, healthy workforce, sustainability, digital solutions

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JÖNKÖPING UNIVERSITY Högskolan för lärande och kommunikation Examensuppsats, 15 hp i Företagsekonomi HR-programmet Vårterminen 2020

SAMMANFATTNING

Jessica Johansson Hillyer, Maria Liljeqvist

Återhämtning i en digitaliserad värld

En induktiv kvalitativ fallstudie om arbetsgivares och arbetstagares uppfattningar om digitala lösningar för att främja återhämtning

Antal sidor: 50

Återhämtning från arbetet är centralt för hälsa och välmående och organisationer har en skyldighet att möjliggöra anställdas återhämtning. Organisationer kan främja anställdas återhämtning genom att implementera strategier och på så sätt nå hållbar utveckling. År 2020 existerar organisationer i en digitaliserad värld, vilken har påskyndat behovet av att implementera digitala lösningar och använda dem för processer. Att uppmuntra och stödja återhämtning är centrala delar i att främja återhämtning och digitala lösningar kan hjälpa båda delar.

Användningen av digitala lösningar inkluderar hur digitala lösningar används och hur de kan användas. Det finns ingen tidigare forskning om digitala lösningar, att främja återhämtning och användning, så vi definierar vårt forskningsfenomen som användningen av digitala lösningar för att främja återhämtning. Vi identifierar vårt forskningsgap i kopplingen av återhämtning och digitala lösningar i en organisatorisk kontext. Genom att beskriva forskningsfenomenet kan vi fylla detta forskningsgap och därmed addera till den befintliga litteraturen om organisatorisk hälsa och välmående. Syftet med denna forskning är att beskriva organisationers användning av digitala lösningar för att främja återhämtning.

Genom att utföra en induktiv kvalitativ fallstudie samlar vi in data genom att utföra en dokumentinsamling och enkätundersökningar online. Vi finner att mobilapplikationer, virtuella assistenter, aktivitetsmätare, virtual reality och smarta el-cyklar kan användas för att främja återhämtning. Vi finner också en gynnsam kontext för både återhämtning och för digitala lösningar för att främja återhämtning. Vidare ser vi potential för att använda de identifierade digitala lösningarna för att främja återhämtning. Vi drar slutsatsen att strategiimplementering bestående av digitala lösningar för att främja återhämtning i organisationer kommer att leda till en högre nivå av hälsosam arbetskraft.

Nyckelord: återhämtning, främja återhämtning, hälsosam arbetskraft, hållbarhet, digitala lösningar

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5.4 Towards a higher level of healthy workforce by using digital solutions for recovery ... 41 6. Conclusions ... 46 6.1 A favorable context for usage of digital solutions to promote recovery in organizations .... 46 6.2 Discussion ... 47 6.3 Practical contributions ... 49 6.4 Suggestions for future research ... 49 References ... Appendices ... Appendix 1: References with links to documents used in documentation review ... Appendix 2a: Survey for employers ... Appendix 2b: Participation request for employers ... Appendix 2c: Message containing link to employer survey... Appendix 2d: Reminder to employers ... Appendix 3a: Survey for employees ... Appendix 3b: Participation request for employees ... Appendix 3c: Message containing link to employee survey ... Appendix 3d: Reminder to employees ... Appendix 4: Tested data collection methods to find a functioning approach ...

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1 In this chapter, we present the chosen subject of work-related recovery including its benefits for individuals, organizations and general health. We emphasize how strategies consisting of activities and practices are crucial for achieving recovery and that strategies should be adapted to today’s digitalized world. We opine that by connecting digital solutions with recovery promotion, we can explore new ways to promote recovery. Next, we present our research phenomenon of the usage of digital solutions to promote recovery followed by presenting our research purpose which is to describe organizations’ usage of digital solutions to promote recovery. Finally, we mention special restrictions due to Covid-19.

1.1 Organizations' role in promoting recovery

Health and well-being are crucial to reach sustainable development and are presented as a key element in the 2019 Global Sustainable Development Report (United Nations [UN], 2019). Individuals’ psychological and physical health affect their capabilities to drive global, social, and economic change, meaning that their health also affects their capabilities to achieve sustainable development. Consequently, health is not only to be seen as a development outcome, but also as a means to achieve crucial aspects of the Sustainable Development agenda. Achieving health and well-being requires contributions by several actors including organizations (UN, 2019). Organizational circumstances affect employees’ health in everyday life (Bendix Justesen, Eskerod, Reffstrup Christensen & Sjøgaard, 2017). To successfully achieve health and well-being, health activities must occur in peoples’ everyday life, and therefore organizations offer an ultimate setting for influencing employees’ health behavior (Bendix Justesen et al., 2017). Organizations can positively influence health behavior by creating and implementing policies, practices and conditions regarding health and wellbeing for employees and thus attain a healthy workforce. Central to health and well-being is recovery (Day, Kelloway & Hurrell, 2014; Rook & Zijlstra, 2006), and without recovery, there is no healthy workforce. The subject that this research is based on is thus recovery. Recovery can be used in different contexts and refer to different things (“recovery”, 2020). This research refers to recovery from work. Recovery from work is when demands from work are removed that allow the individual to reset and refill resources that were lost during the workday (Day et al., 2014). Recovery from work is beyond being crucial to achieve health and well-being in fact part of employers’ obligation and is in some countries even regulated by law (Arbetsmiljöverket [AV], 2018). For instance, in the Swedish Work Environment Authority's regulations on organizational and social work environment, a paragraph on employers’ obligation to promote recovery is included (AFS 2015:4).

Recovery has been shown in several studies to lead to numerous beneficial individual and organizational outcomes (Day et al., 2014; Rook & Zijlstra, 2006; Sonnentag, 2003; Isoard-Gautheur, Scotto-di-Luzio, Ginoux & Sarrazin, 2018). Individual outcomes include increased positive mood, higher life satisfaction and overall well-being (Day et al., 2014), as well as increased vitality (Ejlertsson, Heijbel, Ejlertsson & Andersson, 2018) and better mental health

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2 (Isoard-Gautheur et al., 2018; Day et al., 2014). Individual outcomes further include reduced fatigue, decreased occupational stress and less burnout (Rook & Zijlstra, 2006). Organizational outcomes include employees’ increased motivation and feelings of vigor at work (Isoard-Gautheur et al., 2018; Sonnentag, 2003), proactive behavior (Sonnentag, 2003), work engagement (Sonnentag, 2003), increased job performance (Rook & Zijlstra, 2006; Isoard-Gautheur et al., 2018), dedication (Sonnentag, 2003), organizational efficiency (Isoard-Gautheur et al., 2018) and decreased illness-related absenteeism from work (Rook & Zijlstra, 2006; Faskunger, 2013). Further organizational outcomes of recovery are that it allows for improved task performance, personal initiative and improved organizational community behavior (Day et al., 2014).

According to Hofboll’s COR theory, individuals that have limited resources may be more subsequent to losing resources, and such losses can lead to even more losses in the future (Mansour & Tremblay, 2018). Individuals strive to minimize having few resources or losing resources and take actions to obtain, maintain, foster and protect their resources (Shuhaimi & Marzuki, 2015). A resource is defined as anything that has intrinsic or extrinsic value, for example energy resources and personal resources (Shuhaimi & Marzuki, 2015). That being so, recovery in itself could be argued to be a valuable resource. Certain activities or practices should be carried out since they help protect resources that are currently in possession and assist in attaining more resources, thus enabling the overall conservation of resources (Mansour & Tremblay, 2018). Consequently, in order to both achieve and enable recovery, strategies consisting of activities or practices should be set in place.

Recovery can be achieved by using individual or organizational strategies (Ejlertsson et al., 2018). Individual recovery strategies include engaging in leisure activities, such as social and physical activity (Rook & Zijlstra, 2006). Physical activity has been proven to reduce stress and foster recovery since endorphins that are released during physical activity lowers stress levels in the body (Rook & Zijlstra, 2006). Day et al. (2014) point out that organizations should encourage employees to use available vacation time, which is another example of an individual recovery strategy according to Fritz and Sonnentag (2005). Ejlertsson et al. (2018) agree and highlight that physical and psychological distance from work is central to recovery. Organizational recovery strategies include offering micro breaks (Ejlertsson et al., 2018), wellness programs (Faskunger, 2013), flexible scheduling, flexible work arrangements, compressed work weeks, family leave and days off (Mansour & Tremblay, 2018). Micro breaks have been shown crucial for recovery (Ejlertsson et al., 2018). Day et al. (2014) agree by highlighting the importance of organizations’ encouragement to allow for employees to recover by taking breaks at work. Doing so is part of worksite health promotion which has become more popular among organizations and is used as a way to improve employee health behaviors and reduce costs associated with poor employee health (Kahn-Marshall, Gallant, Allegrante & Barry, 2012). The World Health Organization (WHO) defines health promotion as giving people the opportunity to gain control over their health and improving it in order to reach full physical, mental and social well-being (Pellmer, Wramner & Wramner, 2013). Beyond the traditional strategies to promote health in the workplace, which include assessment of health risks and health education, organizations could also implement policy changes to help employees become involved in healthier behaviors. The worksite is considered an ideal setting

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3 for health promotion since most adults spend a lot of time at work. Further, worksite health promotion can influence a part of the population that traditionally have not been engaged in health activities (Kahn-Marshall et al., 2012).

It is clear that promoting recovery is a central issue of health promotion. Promoting recovery refers to encouraging and fostering recovery (“promote”, 2020). Encouraging recovery means to inspire employees to recover and create awareness of its importance. Fostering recovery on the other hand means to create conditions, such as policies and practices, that enable recovery. Promoting recovery is crucial to achieve health and well-being and to reach sustainable development. Recovery results in numerous beneficial individual and organizational outcomes. Organizations have a possibility to attain these outcomes by enabling recovery strategies. Organizations can enable recovery strategies and thus promote individual recovery among employees by applying solutions. What would such solutions be in 2020’s digitalized world?

1.2 Digital solutions to promote recovery

In 2020, organizations exist in a digitalized world, which has expedited the need to implement digital solutions and use them for processes (Martinez, 2019; Tataru, 2019). Digital solutions are constantly developed (Tataru, 2019). Cijan, Jenič, Lamovšek and Stemberger (2019) show that previous studies focus on the disturbance that digitalization can create, such as blurring work-life balance and negatively affecting health. By constantly having remote access to work, boundaries between work and life are hard to draw, which results in difficulties to switch off when at home (Cijan et al., 2019). However, since digitalization characterizes the world in 2020 and thus cannot be avoided, it would be more appropriate to instead focus on how it can work in our favor. Digitalization has for instance brought digital solutions into our world. Based on the definitions of “digital” and “solution” as per the academic dictionary by Merriam Webster (2020), we conclude that “digital solutions” refers to a process characterized by electronic and especially computerized technology to answer a need. Indeed, in a study by Howarth, Quesada, Silva, Judycki and Mills (2018), using digital solutions in the workplace affected health positively. Encouraging emails were sent out to employees with individualized recommendations and personal challenges targeted toward specific health behaviors (Howarth et al., 2018). Other studies have shown that beyond affecting health positively, digital solutions are used to create behavior change that in turn can promote health and well-being (Webb, Joseph, Yardley & Michie, 2010; Jonkman, van Schooten, Maier & Pijnappels, 2018).

Digital solutions could help both the encouraging and the fostering elements of recovery promotion. To encourage recovery, short message services (SMS) could be used, since they have been proven to both be highly effective and can be used in many different ways (Webb et al, 2010). They could for instance be used to inform employees of the benefits of recovery, provide a cue to engage in recovery strategies and to send motivational messages as reminders. The Internet could also be used to encourage employees to recover by enabling communication, supporting behavior change and delivering interventions (Webb et al., 2010). To exemplify, organizations could by using the Internet offer a live chat function that is open during business hours. Employees could use this live chat function to directly contact an individual, such as a health promotion manager, to get advice on how to recover. Such access to an advisor has been proven to be effective (Webb et al., 2010). Digital solutions could further be used to foster

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4 recovery. Fostering recovery can be exemplified by using our own previous experience, where an organization created conditions through a policy that included two paid 10-minute breaks as part of the workday. These breaks were especially incorporated so that employees should participate in a virtual workout that became available on everyone's computer screens during that time. The virtual workout was accordingly a practice that fulfilled the requirement of the policy. As a result, the combined elements of the policy and the practice fostered recovery. This example describes how an organization could support breaks and as a consequence, also foster recovery by using digital solutions. The encouraging and the fostering of recovery cannot always be distinctly separated and paired with its own type of digital solution. In such cases, both could be needed to together promote recovery. Further, in order for a digital solution to actually promote recovery, it may sometimes need to be used in collaboration with another non-digital solution. To exemplify, mobile applications (apps) will be used. Apps are commonly used to promote physical activity (Lambert, Greaves, Farrand, Haase & Taylor, 2017), and as previously presented, physical activity is an established recovery strategy. To encourage recovery, organizations could use an app that sends out notifications with cues to visit the gym and maybe even reward employees who go to the gym to exercise. The app is thus connected to a specific gym that is affiliated with the organization. Consequently, the gym becomes the practice that would foster physical activity and thus recovery. This example specifies how a digital solution in combination with a non-digital solution could help in both encouraging and fostering recovery rather than in one or the other.

As discussed above, encouraging and fostering recovery are central elements in promoting recovery. Encouraging includes elements of inspiring and creating awareness, while fostering includes creating conditions through policies and practices. Digital solutions could help facilitate both as exemplified above. Recovery promotion by using digital solutions is the core of our thesis as we argue in the next section.

1.3 Reaching a higher level of healthy workforce in 2020’s

digitalized world

As we have discussed before, recovery is crucial for health and well-being and has numerous individual and organizational outcomes. We have also mentioned that recovery can be achieved by using individual or organizational strategies which organizations have an obligation to enable. Further we have pointed out that organizations exist in a world where digital solutions are available and constantly developed. Since digital solutions are constantly developed, we are curious to research digital solutions and how they can be used by organizations to promote recovery.

Day et al. (2018) conclude that further research to explore ways to promote recovery is needed. We believe that exploring such ways can be done by connecting digital solutions and promotion of recovery and studying the combination of the two in an organizational context. Findings in previous research indicate that organizations should take initiatives to promote recovery (Gerber et al., 2019), and our aspiration is to find data that concur with such findings while at the same time involving the aspect of digital solutions. Since promoting recovery is both an obligation for employers and in some countries regulated by business law, there is a

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5 requirement to actually promote recovery in organizations, which makes it relevant to the field of Human Resources. Pellmer, Wramner and Wramner (2013) and Faskunger (2013) mention that health promotion efforts in the workplace are economically viable and even profitable for organizations, which demonstrates relevance to business administration as well, since recovery is part of health promotion. By promoting recovery, organizations are actually reaching economic responsibility and by that, they also reach societal responsibility, which is relevant in today’s discourse in business administration of sustainability. This, again, demonstrates how relevant recovery promotion is for business administration. Our thesis therefore tackles the responsibility of the organization from a business administration perspective, meaning as a way of encouraging and fostering recovery.

Since identifying digital solutions that can promote recovery and how they can be used to promote recovery is relevant, we want to research this area. More specifically, we want to find organizations’ usage of digital solutions to promote recovery. By usage, we mean both how digital solutions are used and how they could be used. Our research phenomenon is thus the usage of digital solutions to promote recovery. The pairing of digital solutions and recovery promotion is rare and adding the usage aspect to it is new.

We claim that considering the strong evidence of work-related benefits of recovery, it should be in organizations’ interests to aid their employees in the recovery process. With existing evidence showing that recovery improves health and is crucial to develop and maintain sustainable workforce well-being (Rebar & Taylor, 2017; Kossek, Valcour & Lirio, 2014), there are even stronger arguments why organizations should promote recovery among employees. An opportunity to improve health and develop and maintain sustainable workforce well-being should be of interest to all organizations that value a healthy workforce and the potential benefits of attaining such workforce. Performing research in this area is further relevant because it supports three of the UN sustainable development goals – good health and well-being; decent work and economic growth; industry, innovation and infrastructure. Furthermore, studying organizations’ usage of digital solutions to promote recovery is meaningful because it can bring suggestions on how organizations can aid their employees to recover. These suggestions are thus ways for organizations to attain a healthy workforce, which in turn could add to both today’s and tomorrow’s working population’s well-being. In other words, digital solutions enable an even higher level of a healthy workforce. Digital solutions add to the traditional way of promoting recovery since organizations thus could encourage and foster using revolutionary methods, which supports a healthy workforce even better. Instead of creating disturbance, we therefore claim that digital solutions create value in relation to promoting recovery in organizations.

As we have mentioned before, there is no research on digital solutions, recovery promotion and usage and thus, the research gap is the connection of recovery and digital solutions in an organizational context. By describing the research phenomenon, we can fill this research gap. Blomkvist, Hallin and Lindell (2018) write that a descriptive purpose is fitting when wanting a better understanding of a phenomenon where knowledge is limited. Filling this research gap will add to the existing literature on organizational health and well-being.

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1.4 Purpose

The purpose of this research is to describe organizations’ usage of digital solutions to promote recovery.

1.5 Special restrictions due to Covid-19

This research was carried out in the spring of 2020 when the world was affected by the so-called Covid-19 crisis. Covid-19 is a virus that caused the global community to pause. Recommendations from WHO and the various authorities in Sweden urged to keep a social distance and avoid meeting others in larger groups for and during an extended period. As a result, tele-working is recommended for many employees and a number of organizations closed the doors to external partners. All this has led to many concerns and worries in our societies and nations.

The Covid-19 context may have influenced this research in an indirect way, but today it can be difficult for us to evaluate this and discuss such indirect consequences.

The Covid-19 context has also directly impacted this work in the following way:

• Requested participants to participate in face-to-face interviews declined to be interviewed in person due to the social distancing recommendation due to Covid-19. • Requested participants did not have time for phone interviews during the Covid-19

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7 In this chapter, we argue for applying the scientific approach of critical realism in our research. We present our research plan where we motivate using an inductive role of theory, performing qualitative research, and our choice to perform a case study on digital solutions. Finally, we argue for how these choices go together and motivate our inductive qualitative case study as one.

2.1 Scientific approach: Critical realism

We believe that the social reality exists independent of our own beliefs, understandings and interpretations of it. This means that when considering the digitalized world in our research, we see it as a matter that exists outside our perception of it, which in turn also brings us to viewing digital solutions as external objects that exist whether we understand them or not. Such belief is according to O’Reilly and Kiyimba (2015) part of the ontological position of realism. Bryman and Bell (2015) add to the description of realism by explaining that realists not only see the world as external but also present the external reality objectively. In our research, we demonstrate such a presentation by dividing our purpose into three aspects: usage, digital solutions and promote, and thus creating themes linked to actual entities. Our ontological positioning of realism also becomes apparent in how we formulate the questions used in our surveys that are part of our data collection. The questions are based on the knowledge that our documentation review resulted in. Further, we do not let our perception or understanding of reality affect what we present since we include examples of a couple of digital solutions that we had difficulties seeing would promote recovery. By making all these choices, we hope to give an accurate image of the usage aspect of our purpose which is part of our study’s research phenomenon.

O’Reilly and Kiyimba (2015) explain that there are different variants of realism. We use the scientific approach of critical realism, which could be argued to be inclined towards realism’s contrariety known as relativism. Relativism, in contrast to realism, claims that reality does not exist outside of the human mind and the world is only knowable through socially constructed meanings. This means that experience, thought and reality is relative to something else. Relativists argue that the reality as seen by realists is inaccessible since the only thing that is accessible is our representation of reality (O’Reilly & Kiyimba, 2015). Based on this view of critical realism, elements of relativism can be seen in critical realism because it sees reality as something that consists of three levels in which one of them comprise peoples' representations of it. Bryman and Bell (2007) describe critical realism as a compromise between realism and relativism. It is “realistic” since it reckons that an objective reality exists regardless of our knowledge of it, and it is “relativistic” since it at the same time acknowledges that concepts used in social sciences are subjective since these concepts are human constructions (Bryman & Bell, 2007). This thought is further elaborated on in Bryman and Bell (2015) where the authors explain that the objective reality gives rise to our impressions and is thus “critical” because even though the impressions made are based on an objective reality, they are not in

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8 themselves objective. This means that critical realists believe that reality exists regardless of our knowledge of it, while our description of reality does not exist regardless since it is heavily dependent on our knowledge. Critical realism further claims that in order to understand and thus also to change the social world, the structures that generate objects in the social world must be identified.

To answer the digital solutions aspect of our research purpose, we must see what digital solutions exist. It is important that we have an idea of the objects we are researching. This is what we could see if we consider digital solutions as part of reality. According to Bryman and Bell (2015), objects of reality can show that our knowledge of our perceptions is in fact incorrect. We choose to formulate questions in our surveys in a way that leaves room for the respondents to show that our knowledge that the identified digital solutions promote recovery may be incorrect. This approach goes hand in hand with the critical realism standpoint that objects are not necessarily what we perceive them to be (Bryman & Bell, 2015). Using this approach further allows us to reach a result that may point to that even if the documentation review leads us to identify a certain digital solution that can be used to promote recovery, it may be shown in our surveys to not necessarily be used for promoting recovery. In this regard, we wish to leave room for unexpected results that may challenge our ideas and force us to rethink. For such challenging results to be possible, an objective reality outside of our beliefs about it must exist. For all these reasons, we want the specific ontological perspective of critical realism to imbue our research.

2.2 Research plan

Now that we have explained our scientific approach of critical realism, we discuss how we approach our research.

2.2.1 Inductive approach

As mentioned above, the objects in our research are digital solutions, and we see digital solutions from a critical realist perspective. Although we know that the objects in our research are digital solutions, we do not exactly know what the digital solutions are. We exemplify how digital solutions can be used for recovery in the introduction of this thesis, but we do not know if they are used for that reason. If digital solutions are used for recovery has to do with usage, which is another aspect of our purpose. When we look at both the digital solutions aspect and the usage aspect, we see that there is something there that we need to better understand. Since we do not know what the digital solutions are and since it is apparent that we neither know what usage really is, we must collect and view different empirical data in order to develop possible theoretical explanations of it. Based on this, we collect data and are open to what may show in our research. Further, as critical realists we challenge the understanding of knowledge by identifying how digital solutions can be used and how they actually are used in organizations. By examining these aspects, we can compare and see if they differ. If they differ, we may understand such a potential divergence by connecting the generated data to different theories.

These arguments display the uncertainty of what the data in this research will result in, which in turn makes us unbeknownst to what theories will be applicable. On that account, we find it

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9 wise to collect data first, since this according to Blomkvist et al. (2018) is a good method to identify which theory could be of interest when analyzing the data. Based on these arguments and on our critical realism scientific approach, we find an inductive role of theory appropriate to our research (Bryman & Bell, 2015).

According to Bryman (2011), many inductive studies generate interesting and informative results, but their theoretical significance is not always that obvious. However, development of theory is central to critical realism (Bryman & Bell, 2015), and as critical realists we separate the results and our impressions of the results and therefore, we believe we can connect the objective results to a relevant theory. As critical realists, we also see theory as tentative, which enables us to change theory if we cannot see a clear connection.

While performing our research, it becomes important for us to have a clear idea of digital solutions and the usage, since these are main parts of our purpose. In terms of making these aspects more practical and easier to handle, we use our inductive approach and develop empirical research questions over time. These questions have great significance for our choices in our method, since they not only help us perform our research, but also lead to a certain logic in our research. Our empirical research questions are:

ERQ1: What digital solutions exist that organizations can use to encourage and foster recovery?

ERQ2: How are digital solutions to promote recovery used and perceived in organizations? We argue more for these questions in section 3.2 and 3.3.

2.2.2 Qualitative research

To decide what type of data is considered most suitable in responding to our purpose, we employ choices already made. An inductive role of theory is chosen, and such strategy is according to Bryman (2011) often paired with a qualitative approach since it helps to develop concepts and theories.

One aspect of our purpose is as mentioned the usage, which involves finding out how organizations use and can use digital solutions to promote recovery. To answer the usage aspect of our purpose, we believe that in-depth knowledge of the link between digital solutions and how they can promote recovery is necessary. Beyond the already mentioned aspects of digital solutions and usage, our purpose includes to describe digital solutions. We find that words are more applicable than numbers in responding to such a purpose, since words are descriptive in nature whereas numerical data can be limited without descriptive content. Based on these arguments, we choose to apply a qualitative approach in our research.

Qualitative research is often combined with certain choices, but it is not always easy to keep the research in a fixed position (Bryman, 2011). As critical realists, we do not expect all choices made in this research to be obvious to the qualitative approach, so we allow a couple of features that normally are paired with quantitative research. Such features include that we are involved in distance to our participants by collecting data by documentation review and surveys rather than performing for example interviews or using other data collection methods that would place

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10 us in proximity to our research participants. Further, a structured design of questions is used rather than an unstructured one.

2.2.3 Case Study

Since our research phenomenon is the usage of digital solutions to promote recovery, we argue that it is a new phenomenon. Even though digital solutions and recovery promotion on their own have been previously covered in research, our initial literature review shows that they have rarely been paired and thus neither been researched together with the usage aspect as one phenomenon. Yin (2018) argues that whenever the focus of a research is a contemporary phenomenon rather than a historical one, a case study is fitting.

Blomkvist et al. (2018) write that when the researchers are open to discovering new dimensions by using a descriptive purpose, a case study is suitable. In line with our choice of using an inductive role of theory, it is yet to be settled what our empirical data may result in. According to Blomkvist et al. (2018), the cornerstone of performing a case study is to be open and susceptible to the empirical material and for that reason, a case study is often paired with an inductive role of theory. Our hope is to provide organizations with ideas on how they can aid their employees to recover. Blomkvist et al. (2018) point out that when aspiring to collect interesting and relevant material for a targeted audience, a case study is appropriate. Based on these reasons, we choose to perform our research in the design of a case study.

As mentioned, our research phenomenon is a new phenomenon. To better understand our phenomenon, we need to have different voices to help us bring together the digital solutions with the usage. We believe that these voices could be employers and employees. Based on our critical realism scientific approach, employers and employees are selected as cases for this research since they are objects of reality that can help us understand our research phenomenon. In a case study, one or several cases are chosen to describe a phenomenon (Blomkvist et al., 2018), so employers and employees are further chosen to describe organizations’ usage of digital solutions to promote recovery.

2.2.4 Inductive qualitative case study

Using an inductive role of theory allows us to over time better understand digital solutions and the usage as part of our purpose. To make the usage aspect more practical, the inductive role of theory further allows us to develop empirical research questions which help us collect relevant data to digital solutions and usage. Using our inductive role of theory together with a qualitative approach enable us in such a way to develop theories based on the in-depth knowledge we acquire from collecting qualitative data needed to describe digital solutions and usage. By performing an inductive qualitative case study, we make it possible to collect different views on how digital solutions are perceived in relation to recovery, and these different views provide us with the information needed to give us a complete picture of the usage aspect of our purpose. When combining all these choices with the empirical research questions we develop by performing an inductive qualitative case study, we can describe the research phenomenon and answer the purpose of this research. This is illustrated in figure 1.

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11 Figure 1: Inductive qualitative case study

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12 In this chapter, we first present the process of deciding what our research purpose should be, including how we problematized and developed our research phenomenon. Since we collected empirical data in two stages, we discuss each stage separately: first, we discuss methods used in our documentation review, then we discuss methods used in our qualitative online surveys. Next, we motivate how and why we chose the selected theories to analyze our data. Then, we discuss this research’s quality in terms of validity, reliability, and source criticism. Finally, we discuss ethical considerations.

3.1 Initial Literature Review

To focus our subject into a research phenomenon, we started our research by performing a literature review. Our choice of the subject “recovery” was based partially on our general interest in health and well-being. Courses taken as part of our education in Human Resources created a specific interest for recovery. Learnings as Human Resource students have been that enabling employee recovery is an organizational strategy to maintain or achieve a healthy workforce, which in turn is a main focus in Human Resource Management. To focus our subject of recovery relevant to an organizational context, we searched for terms including different ways of referring to recovery such as “recover” and “recovery”. We used these terms together with different ways of referring to the organization, such as “organization”, “organizations”, “organizational” and so on. These searches resulted in an overwhelming amount of hits, so we decided to specify our subject further.

We were curious to find a creative and innovative approach that organizations can use to promote recovery, since insufficient recovery is an increasing problem in today's society and therefore a problem that should be handled. Based on our curiosity, we wanted to think outside the box and started discussing what characterizes the world today and immediately thought of digitalization. We discussed this further and agreed upon including a digital aspect in our research, since this went well with today’s digitalized world. This led us to increase our search and also include some form of digitalization, by using terms like “digital”, “digitalization”, and “digitalized”. Based on our interest in a digital aspect, we specified our research phenomenon to be the usage of digital solutions to promote recovery. Next, we continued our search in the university’s database for research articles that mentioned the connection of recovery and digital solutions in an organizational context by using different versions of the same search terms already described and realized that the connection was unexplored. Thus, we identified our research gap. Our research gap led to our research purpose.

3.2 Documentation review

3.2.1 Collection

In order to answer the digital solutions and usage aspects of our purpose, we first needed to look at the digital solutions. This led us to develop ERQ1 which is “What digital solutions exist

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13 that organizations can use to encourage and foster recovery?”. ERQ1 helped us choose an appropriate data collection method to answer the digital solutions aspect of our purpose. The method chosen was a documentation review based on secondary data.

The documentation review consisted of viewing secondary data available through several online sources such as government and corporate websites, news articles, marketing material including press releases and blogs from technology and health companies. Bryman (2011) writes that virtual documents constitute a relevant source in qualitative research and that when collecting virtual documents, the majority of attention is given to online sources and websites. Considering the limited time to perform our research, we found it efficient to use a documentation review as a data collection method, since we knew that already produced data on digital solutions in relation to health promotion existed after having found it in our initial literature review. We figured that to single-handedly use primary data collected through other methods would increase the risk of not providing enough data to answer our research purpose in full.

The documentation review consisted of three main steps, which together resulted in both inclusion and exclusion criteria (see table 1). All materials chosen to be included in our documentation review have met the inclusion criteria. Any material that met the exclusion criteria were excluded from our documentation review.

Table 1: Inclusion and exclusion criteria for materials in documentation review

Inclusion criteria Exclusion criteria

Documents about digital solutions to promote health that were repeatedly mentioned in different documents.

Documents mentioning SMS, emails and live chat functions where chatting is done with human beings.

Documents that were recently published (2017 and forward). Documents that discussed digital solutions in relation to the wrong king of recovery.

Documents mentioning existing digital solutions or digital solutions that are in the process of launching.

Documents published before 2017

The first step in our documentation review included finding relevant search combinations. This process started with a general search for “health promotion and recovery” using the search engine Google that led us to an article from WHO’s newsroom. After being redirected to WHO’s website, we continued our search on its website, since the organization being the leading global health organization is a reliable source that plausibly would have data relevant to answer our purpose. Unfortunately, we did not find data relevant to answering our purpose, which led us to go back to Google and continue our search there using the initial search word combination. Realizing that the search combination was too narrow, we broadened our search

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14 combination to “health promotion”, which instead resulted in an overwhelming amount of hits. We specified our search word combination to “digital solutions to promote recovery” to give us a more targeted representation of documents but got mainly irrelevant hits that covered the wrong kind of recovery relating to recovering from physical injuries, diseases, substance abuse and addiction, and even to recovery of lost data. Although the majority of hits were irrelevant, we got a few usable hits that concerned health promotion in general. This resulted in us changing the search term again to “digital solutions to promote health”. Since recovery was shown in our initial literature review to be a crucial part of health promotion, we argue that this search combination was equally as relevant as those including “promote recovery”. Changing the search term to “digital solutions to promote health” resulted in that we included material about digital solutions and health promotion, as long as we noticed that the digital solutions also could be used to promote recovery. Consequently, a few digital solutions that were not specifically mentioned together with recovery, but rather together with health, are included in chapter 4: Digital solutions to promote recovery. It is worth mentioning that also included in the same chapter are digital solutions that can promote recovery but are not necessarily used for that specific reason. The decision to include such solutions goes hand in hand with our critical realism research approach and its preference to present objects of the external reality objectively. The first step of our documentation review ended in us using “digital solutions to promote health” and “digital solutions and health promotion” when searching Google, since these search term combinations gave us enough material to answer the digital solutions aspect of our purpose.

The second step in our documentation review consisted of finding relevant sources using the search term combinations. We allowed for a snowball effect to take place throughout our search, since we permitted ourselves to get inspiration from relevant hits and use information found in these documents to continue our search. The snowball effect further occurred when we, based on hits that indicated that relevant information could be found through other types of sources, searched these sources for information as well. An example of this is when the search word combination “digital solutions to promote health” resulted in a hit with a link to the online magazine “New Technology”. Even though the information found through that specific link was not 100% relevant to answer the digital solutions aspect of our purpose, it was still relevant since it not only gave us knowledge about the digital solution per se but also gave us the idea that technology websites may be good sources to collect information about digital solutions in general. Based on that this approach 1) helped us locate relevant sources that we initially had not thought of; 2) gave us general knowledge on digital solutions, which we found necessary to include in the result; and 3) gave us knowledge on how digital solutions could be used to encourage and foster recovery and/or health, we found the snowball effect to be a useful strategy in the data collection for our documentation review.

The third and last step in our documentation review included deciding what material to include and exclude from our search. We decided to exclude any material on SMS, emails, and live chat functions where chatting is done with human beings. This decision was based on the fact that we had already identified such solutions in our initial literature review. Initially, we intended to only include material published 2019 and forward to assure using sources relevant to our purpose, which indirectly includes an aspect of digital solutions being relevant to 2020.

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15 However, when executing our search, we found sources with material published 2017 and 2018 that also were relevant to 2020. As a result, we included documents published 2017 and forward. Further, we wanted to be as up to date as possible, so we decided to include one digital solution that is not yet on the market but is in the process of being launched when writing this paper. We think that this choice goes hand in hand with our realistic ontological position. Having an external perception of reality means that we perceive digital solutions as existing objects, whether they currently are available on the market or if they are about to be. In total, after completing the third and final step, 21 documents were selected that provided us with sufficient information to answer the digital solutions aspect of our purpose. As a side note, the documents used to produce chapter 4 were part of our empirical data and not references per se, and therefore we created an appendix for the sources used (see appendix 1) and did consequently not include these sources in our regular reference list. We have taken necessary measures to find out how to properly refer continuously throughout the text but have not been successful in finding the correct way. Therefore, we referred ordinarily in that chapter.

3.2.2 Scanning of documents

Documents were initially scanned separately in order to get an overview of as many documents as possible when searching for digital solutions that could promote recovery. When we found a document that seemed relevant, it was shared with each other. We chose this method since it allowed for further scrutiny and led to a more critically reviewed sample of documents. When scanning documents, we learned that many digital solutions had been updated and developed into more complex versions than that of their origin. We had in our initial literature review already gotten proof about how important it is to adapt in today’s digitalized world. Based on the scanned documents and that insight, we immediately thought of Kurt Lewin’s change theory, which we had learned about in several courses taken as part of our university program in Human Resources.

The selected documents led to an intermediate result which helped us take the next step in our data collection and ultimately design our surveys with relevant questions. The completed surveys were later analyzed.

3.3 Qualitative online surveys

3.3.1 Collection of data

In order to bring together the two aspects of digital solutions and usage, and thus understand our research phenomenon, we decided to look at how the identified digital solutions were perceived. As critical realists, we were aware that peoples’ understanding of reality are subjective and therefore, we were also aware that employers and employees may have different views of digital solutions to promote recovery. We decided to collect both employers’ and employees’ opinions to see both groups’ views, since we thought this was a good way to generate knowledge about the usage aspect of our purpose and also necessary to fully understand it. Collecting opinions from different voices belonging to the specific groups who can use digital solutions in organizations and who can receive recovery-related advantages

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16 from it seemed highly relevant. Doing so also went well with our applied critical realism scientific approach in which one level of reality comprises peoples’ representations of it. For us to be able to truly describe the usage of digital solutions to promote recovery, we needed to hear from both employers and employees. This idea led us to develop ERQ2 which is “How are digital solutions to promote recovery used and perceived in organizations?”.

ERQ2 helped us collect data relevant to answering the usage aspect of our purpose. The general data collection tool used to answer the usage aspect of our purpose was online surveys, which were created using the web-based tool Esmaker developed by Entergate AB. Two qualitative online surveys were created, one for employers (see appendix 2a) and one for employees (see appendix 3a) to facilitate collection of both groups’ opinions. Using the results from the documentation review, we were able to compose relevant questions for both surveys. To ensure validity in our surveys, we composed questions that were clearly connected to our empirical research questions. We also based our questions on our ambitions to acquire answers that would help us answer ERQ2 and the usage aspect of our purpose. Our documentation review led us to discover a potential theory (change theory) that we kept in mind when formulating questions for employers. Change theory was only kept in mind when formulating questions for the employer survey because we saw that it was specifically relevant to an employer perspective. It is after all employers who have the power to make changes relating to digital solutions in their organizations, and not employees. When creating the employer survey, we composed part of the questions based on change theory but not all, since we at this time still were unsure if change theory would be applicable or not. Because of this ambiguity, we left some questions free of influence from change theory. In this way, we allowed for a chance to see another potential theory development from the survey. Based on the prevision of change theory, we created questions that would allow for answers to validate if change theory was applicable or not.

In line with our choice of performing an inductive qualitative research, we created open-ended questions without giving any options for the respondents to choose from and only providing them with empty boxes to answer in their own words. The choice of having open-ended questions was in addition to our qualitative research and our inductive role of theory also based on our critical realistic approach. Open-ended questions allowed us to see the respondents’ perceptions of digital solutions to promote recovery, which we as critical realists see as independent from the digital solutions themselves and also independent from our knowledge of how the digital solutions can be used. In addition to the open-ended questions used throughout our surveys, we used introducing questions to ensure that the respondents in fact belonged to the population we wanted to reach.

After creating both surveys, we tested them by sending them to two acquaintances representing each respondent group. Blomkvist et al. (2018) recommend this strategy to get as relevant feedback as possible. Testing was done to ensure that the questions were well formulated and easily understood and to give us an idea of how long they took to complete. We wanted some kind of time estimation, so that we could include that information in the participation requests that we planned to send out to potential respondents. After testing was done, we published our surveys and set an end date for them. We then sent out participation requests (see appendix 2b

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17 & 3b) to potential respondents via digital channels including email and messenger. We asked a total of 20 people to participate, ten employers and ten employees, and all of them agreed to participate. The requested respondents who agreed to participate then received another email or message containing the link to the survey (see appendix 2c & 3c) which included information on the purpose of our research and how we planned to use the data. When the end date for our surveys was coming up, we sent out reminders (see appendix 2d & 3d) to all respondents who had agreed to participate to counteract low response rates.

To sum up, at this point in our data collection process, we had first performed a documentation review to answer ERQ1. We used the information that the documentation review had given us to formulate questions for our surveys. Then, we collected primary data from employers and employees through qualitative online surveys to answer ERQ2. During this process, we tested other data collection methods first (see appendix 4) that did not work for several reasons but resulted in learnings that helped us find a functioning approach. Our surveys were ultimately developed based on these learnings.

PARTICIPANTS

Subjects in our research included both documents in our documentation review and respondents to our surveys. How documents were chosen has already been discussed in section 3.2 Documentation Review, whereas how respondents were chosen is discussed below.

Since we wanted to collect data from the two voices of employers and employees to answer ERQ2, we decided to use a non-probability sampling method. Bryman (2012) writes that participants are selected because of their relevance to the study’s research questions. We further choose non-probability sampling because, according to Bryman (2012), a non-probability method is common when performing qualitative research. We applied a purposive sampling technique in which we did not want to sample research participants randomly. Bryman (2012) means that the goal of purposive sampling is to strategically sample participants to ensure that they are relevant for the research questions. Purposive sampling helped us get a variety in characteristics among participants. When using a purposive sampling, the researcher decides certain criteria that each participant must meet in order to be selected for the research (Bryman, 2012). Our criterion was people who currently work (employers and employees).

In addition to using a purposive sampling method, we used convenience sampling. Bryman (2012) describes convenience sampling as using a sample that is simply available and accessible to the researcher. We chose a convenience sample since we thought that by asking people whom we knew or had in some way easy access to, we would get a good response rate. We were aware that using convenience sampling could lead to a difficulty in generalizing the findings, but since we used it together with purposive sampling, we knew what population the sample was representing. Even though we sampled people we had easy access to, they were all part of our employer/employee population.

We applied a convenience sampling by selecting respondents whom we knew personally to provide an employee view in our surveys. We applied a purposive sampling in order to ensure that our research participants represented a heterogeneous sample of employees. This was made possible by mixing a convenience sampling with a purposive sampling. Using this mixed

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18 strategy allowed us to quickly find respondents of different gender and age working in different industries in both the private and public sector. Consequently, mixing convenience and purposive sampling helped us obtain a well-represented sample of employees and thus increase our chances of getting a true understanding of our employee population in order to help answer the usage aspect of our purpose. Ten respondents of different gender and age who work in different industries and sectors answered our survey that was created to catch the opinions of employees.

When selecting respondents to provide an employer view, we used the same mix of convenience and purposive sampling. However, as opposed to selection of respondents from the employee group, we did not only request people for the employer view whom we knew personally. The reason is that we did not have enough contacts in our personal network who fitted the employer group. We knew however some people who belonged to this group whom we requested. To find more participants, we thought of people who, although we did not know personally, had somehow crossed our paths and requested them as well. Equivalent to how we selected respondents for the employee view, we located respondents representing different characteristics here as well. After requesting a total of ten employers who agreed to participate, we sent them the employer surveys. Only six employers answered the surveys before the end date, which we discussed and agreed not to be a problem due to several reasons. First, they represented our employer population well, considering they were of different gender and age and worked in different industries and sectors. Second, we had decided beforehand to be open to the number of respondents due to both our inductive approach and the Covid-19 crisis. Third, we looked over the answers and established that empirical saturation had been reached after noticing that the respondents had provided answers rich in quality. Based on these arguments, we decided that six respondents were enough to provide an employer view, since they gave us what we needed to answer the usage aspect of our purpose.

3.3.2 Analysis of the surveys

In this section, we explain how we analyzed the data collected from our two surveys. The data collected in our documentation review was used in our surveys and did thus not need to be analyzed on its own.

A thematic analysis is according to Blomkvist et al. (2018) a method where different themes help answering the research questions. The idea is that themes create patterns which can show something of interest relating to the research phenomenon. There are different ways to decide which themes should be used. Qualitative data tend to appear from the empirical data (Blomkvist et al., 2018). We created themes based on the data that our documentation review resulted in. We had these themes in mind when creating our surveys, and we composed questions from these themes. Doing so helped us sort the data from start which allowed for a smoother data analysis. Since we had two sets of data from employees and employers, data analysis was executed in two sets where we first focused on the employee surveys and then on the employer surveys. We used the same approach for both sets which is explained in detail below.

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19 Initially, we read all answers in our surveys together to get an overview of the answers and find potential issues such as if respondents had not answered the questions. Next, we printed out all surveys on paper and numbered them from 1-10 (employees) and 11-16 (employers). We read all answers on our own and highlighted keywords. We continued by separately color coding the answers. We had two sets of papers for each respondent which led us to do it completely on our own without being influenced by the other’s coding. Questions that led to “yes” or “no” answers were marked depending on the answers. We marked all no’s with a black cross and all yeses with a green checkmark. All “maybe” and “I don’t know” answers were marked with a purple question mark. Questions that required more elaborate answers or respondents to explain “why” were marked by drawing circles around all information we thought of as quality answers that could help us answer ERQ2 and thus also the usage aspect of our research purpose. When we were done with this process, we compared our papers and noticed that we had almost identical color coding. Further, we picked out what we thought was the most important information and wrote annotations consisting of that information in the margin of the paper. Some comments were also made in the margin to clarify certain answers.

Next, we coded the papers by organizing answers in themes using a table in Word. The main questions in our surveys included asking if the respondents believed that the different digital solution could contribute to recovery, and if so, why or why not. We themed data by creating a table with five rows, one for each digital solution, and four columns for “yes”, “no”, “it depends”, and “maybe”. Then we wrote the respondents number in the correct column. This allowed us to easily review the code and see how many respondents believed in each solution by counting the numbers in each column. It also allowed us to see which respondent believed in which digital solution and thus easily compare employers’ and employees’ responses. Next, we continued the coding process by gathering similar answers to the question “why”/”why not” with each other in order to select answers that we wanted to include in our presentation of data. We chose to present the answer that was highest in quality in relation to the question and could thus ensure validity to ERQ2 and to our entire research. By circling quality answers in our color-coding process, we were not only able to select which material to include in our paper but also which answers we thought were relevant to include as quotes. Next, we wrote down everything we wanted to include in our paper in a systematic way by writing the number of the respondent next to each piece of information, so that we easily could find it later if necessary.

3.4 Overall analysis

Using an inductive approach, we collected data and found theories to use along the way. See figure 2 for an overview of data collection and analysis. Our data showed that respondents to our surveys had a positive view of digital solutions for recovery promotion and that a willingness to use digital solutions for recovery existed. As realists, we understood that although one person from one organization felt that way, it did not speak for the entire organization. If digital solutions to promote recovery is a strategy that an organization wants to implement, it involves an element of change. Knowing that change in organizations is difficult and often met with resistance, we again thought of Kurt Lewin’s change theory. Since Lewin’s theory of change is founded in understanding individual behavior, it was relevant when analyzing the data on employers’ and employees’ actual usage of digital solutions.