Framework for Health-Promoting Environments for Office Workers: Photovoice Study.

Background: Office work is increasingly carried out outside conventional office settings, particularly during and after the COVID-19 pandemic. This highlights the need to understand the complexity of aspects that may influence health across different office work environments. Objective: This study aimed to (1) identify aspects that office workers perceive as supporting or hindering their health during office work, and (2) formulate novel questions about office work for quantitative studies. Methods: In February 2021, we conducted a digitally distributed photovoice study in Sweden, in which a convenience sample of 17 office workers from 5 companies took photos and provided written comments on what they perceived as supporting or hindering their health in places where they performed office work. For objective 1, we carried out both qualitative formal analysis and analysis without a theoretical frame, as well as quantified the content of the photos and comments. The identified aspects and their interactions were summarized in a visual framework. For objective 2, findings from the photovoice study were used to adapt selected items from the 2019 Swedish Work Environment Survey, capturing office work performed across multiple settings. Results: Of a total of 63 photos, 70% (44/63) were taken at home, 24% (15/63) in an office, and 6% (4/63) outdoors. The comments on photos taken in conventional office settings largely highlighted health-promoting aspects, while the interpretations of home office photos showed greater variability regarding their impact on health. We identified 9 aspects and categorized them into two groups: (1) environmental perspective, including space, ergonomic, technical, and aesthetic-sensuous aspects and (2) behavioral perspective, including flexibility, focus, breaks-recovery, physical activity, and eating habits. Whether the aspects supported or hindered health depended on the environment where office work was performed and the employees' living conditions. Our visual framework illustrates how these two perspectives interact with each other, bridged by space and flexibility. The study also resulted in a battery of multiple-choice questions about work in offices, at home, in public places, and outdoors that can be used in future research to better capture variation in modern work arrangements. Conclusions: This study extends the notion that office environments play a central role in supporting employee health by suggesting that this also applies to home offices. The results emphasize the need for tailored health-promoting interventions that account for the diverse environments in which office work is performed and for individual needs. The developed visual framework for analyzing health-promoting work environments for office workers and the battery of survey questions can contribute to future research and the advancement of sustainable, health-promoting office environments.