Navigating the Path to Employee Job Retention and Engagement in US Health Centers: A Moderated Mediation Analysis.

Abstract

Goal: This study examines the impact of supportive processes, work-life balance, and leadership on employees' job satisfaction, intention to stay, and job engagement at US health centers.

Methods: This study utilizes secondary data from the Health Center Workforce Well-Being Survey conducted by the Health Resources and Services Administration from late November 2022 to mid-February 2023. We conducted cross-sectional moderated mediation analyses using Model 60 from the Hayes PROCESS macro to examine the effects of supportive health center processes, work-life balance, and leadership on employee job satisfaction and, subsequently, employees' intentions to stay and job engagement.

Principal findings: The mediation analyses demonstrated that job satisfaction mediates the relationship between supportive processes and both intention to stay and job engagement. Moreover, work-life balance and leadership moderate the relationship between supportive processes and job satisfaction with different patterns. Leadership also plays a dual moderating role, reducing dependence on job satisfaction for employee intention to stay while amplifying its effect on job engagement.

Practical applications: Our findings highlight the need for targeted workforce strategies in health center settings. Healthcare leaders should first enhance employees' job satisfaction by investing in workplace supportive processes, work-life balance initiatives, and leadership development tailored to their organizational context. After job satisfaction is strengthened, its influence on employees' intention to stay and job engagement remains contingent on leadership. The decision about how much to invest in leadership initiatives should be guided by the organization's current job satisfaction levels.