The Supply chain Health INitiative Evaluation (SHINE) study protocol: evaluating health and wellbeing services delivered through the supply chain

Abstract

Abstract Background While three-quarters of Small and Medium Sized Enterprises (SMEs) provide some form of health and safety training to their employees, more comprehensive health and wellbeing services (HWS), including health prevention and occupational health activities are notably scarce and rarely evaluated. We will assess if providing HWS through Large Enterprises and Organisations (LEOs) with whom the SMEs already work would be an acceptable and effective model to improve access to HWS. Methods We will conduct a prospective, randomised, cluster study, involving equal numbers of intervention and control SMEs (with between 10 and 249 employees) from the supply chains of three UK LEOs operating in the transport, healthcare and manufacturing sectors. We will aim to recruit a total of 24 SMEs (12 per study arm, eight per LEO), but will accept a minimum of 18 SMEs if timely recruitment is difficult (nine per study arm, six per LEO). Intervention SMEs will receive a 12-month, tailored and co-designed, LEO-delivered multi-component HWS package. Likely components include promoting workplace health, including mental health, and training workplace managers in wellbeing conversations. Trained study ‘champions’ in each SME will support intervention delivery, working with qualified health and work advisors to promote services and coordinate HWS activities. Control SMEs will not receive the HWS intervention and will operate under business as usual. Our primary outcome will be work engagement, which will be assessed at baseline, 6, 12 and 18 months using multilevel regression models, with employees nested within SMEs. A process evaluation and qualitative thematic analysis will assess obstacles and enablers of implementation. A discrete choice experiment will assess the SME leaders’ preferences and willingness to pay for HWS across different sectors. Economic evaluation of the intervention will incorporate Cost-Consequence and Social Return on Investment frameworks. Discussion The study will provide insight on the acceptability and effectiveness of delivering HWS to SMEs in this way. This could inform governmental and organisational policy on how to improve access to HWS among SMEs in the UK. Trial registration The study was registered on the Open Science Framework on the 1st of December 2025 (DOI 10.17605/OSF.IO/PRW6F) and was registered on the ISRCTN on the 31st of March 2026 (ISRCTN17324653). This paper relates to Version 2.1 of the SHINE study protocol, which was finalised on the 28th of October 2025.