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Purpose

This paper aims to explore a health at work initiative (“Fair Chance at Work”) for small and medium sized enterprises (SMEs) and identify opportunities for improving engagement of businesses in such activities.

Design/methodology/approach

A case study approach is used

Findings

Two problems are identified ‐ engagement and participation. A model of engagement incorporating aspects of Prochaska and DiClemente's transtheoretical model of behaviour change is proposed based on findings from the case study and existing literature. It is concluded that improving the engagement of SMEs requires a greater understanding of their current needs, perceptions and attitudes towards health at work. Schemes such as the Teaching Companies Scheme could be useful in testing the model.

Research limitations/implications

The Teaching Companies Scheme could be useful in testing the model.

Practical implications

These findings may inform the development of health promotion projects to SMEs using an applied model behaviour change.

Originality/value

This paper is useful to health promotion workers when developing projects in SMEs.

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