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First-generation college students in the United States are a unique demographic that is often characterized by the institutions that serve them with a risk-laden and deficit-based model. However, our analysis of the transcripts of open-ended, semi-structured interviews with 22 “first-gen” respondents suggests they are actively deft, agentic, self-determining parties to processes of identity construction that are both externally imposed and potentially stigmatizing, as well as exemplars of survivance and determination. We deploy a grounded theory approach to an open-coding process, modeled after the extended case method, while viewing our data through a novel synthesis of the dual theoretical lenses of structural and radical/structural symbolic interactionism and intersectional/standpoint feminist traditions, in order to reveal the complex, unfolding, active strategies students used to make sense of their obstacles, successes, co-created identities, and distinctive institutional encounters. We find that contrary to the dictates of prevailing paradigms, identity-building among first-gens is an incremental and bidirectional process through which students actively perceive and engage existing power structures to persist and even thrive amid incredibly trying, challenging, distressing, and even traumatic circumstances. Our findings suggest that successful institutional interventional strategies designed to serve this functionally unique student population (and particularly those tailored to the COVID-moment) would do well to listen deeply to their voices, consider the secondary consequences of “protectionary” policies as potentially more harmful than helpful, and fundamentally, to reexamine the presumption that such students present just institutional risk and vulnerability, but also present a valuable addition to university environments, due to the unique perspective and broader scale of vision their experiences afford them.

This study aims to investigate the mediation effects of employee voice and employee well-being on the relationship between relational leadership and organizational citizenship behavior.

This study used a Web-based survey method to collect data from 301 respondents in the four public hospitals of the Sekondi-Takoradi Metropolis. This study used PLS-SEM (WarpPLS) to test the study’s hypotheses.

The findings show that relational leadership has a positive impact on organizational citizenship behavior, and that this link is mediated in part by both employee voice and employee well-being.

This study demonstrates the importance of leaders, paying close attention to employees’ well-being and opinions when attempting to drive organizational citizenship behavior in the health sector.

Based on the review of the extant literature on the impact of leadership on employee behavior and to the best of the authors’ knowledge, it is likely that this study will be the first to show how relational leadership, employee voice, employee well-being and organizational citizenship behavior are related in the health sector, thereby advancing the thrusts of the social exchange and relational leadership theories.