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Anger WK, Dimoff JK, Alley L. Addressing Health Care Workers' Mental Health: A Systematic Review of Evidence-Based Interventions and Current Resources. Am J Public Health 2024; 114:213-226. [PMID: 38354343 PMCID: PMC10916736 DOI: 10.2105/ajph.2023.307556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2023] [Indexed: 02/16/2024]
Abstract
Background. Mental health is declining in health care workers. Objectives. To provide a comprehensive assessment of intervention literature focused on the support and treatment of mental health within the health care workforce. Search Methods. We searched online databases (e.g., Medline, PsycINFO). Selection Criteria. We selected manuscripts published before March 2022 that evaluated the target population (e.g., nurses), mental health outcomes (e.g., burnout, depression), and intervention category (e.g., mindfulness). Data Collection and Analysis. Of 5158 publications screened, 118 interventions were included. We extracted relevant statistics and information. Main Results. Twenty (17%) earned study quality ratings indicating design, analysis, and implementation strengths. Randomized controlled trials were used by 52 studies (44%). Thirty-eight percent were conducted in the United States (n = 45). Ninety (76%) reported significant changes, and 46 (39%) reported measurable effect sizes. Multiple interventions significantly reduced stress (n = 29; 24%), anxiety (n = 20; 17%), emotional exhaustion or compassion fatigue (n = 16; 14%), burnout (n = 15; 13%), and depression (n = 15; 13%). Authors' Conclusions. Targeted, well-designed mental health interventions can improve outcomes among health care workers. Public Health Implications. Targeted health care‒focused interventions to address workers' mental health could improve outcomes within this important and vulnerable workforce. (Am J Public Health. 2024;114(S2):S213-S226. https://doi.org/10.2105/AJPH.2023.307556).
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Affiliation(s)
- W Kent Anger
- W. Kent Anger and Lindsey Alley are with Oregon Health & Science University (OHSU), Oregon Institute of Occupational Health Sciences, Portland, OR 97233. Jennifer Dimoff is with University of Ottawa, Telfer School of Management, Ottawa, Ontario, Canada
| | - Jennifer K Dimoff
- W. Kent Anger and Lindsey Alley are with Oregon Health & Science University (OHSU), Oregon Institute of Occupational Health Sciences, Portland, OR 97233. Jennifer Dimoff is with University of Ottawa, Telfer School of Management, Ottawa, Ontario, Canada
| | - Lindsey Alley
- W. Kent Anger and Lindsey Alley are with Oregon Health & Science University (OHSU), Oregon Institute of Occupational Health Sciences, Portland, OR 97233. Jennifer Dimoff is with University of Ottawa, Telfer School of Management, Ottawa, Ontario, Canada
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Aebi NJ, Baenteli I, Fink G, Meinlschmidt G, Schaefert R, Schwenkglenks M, Studer A, Trost S, Tschudin S, Wyss K. Facilitators and barriers of routine psychosocial distress assessment within a stepped and collaborative care model in a Swiss hospital setting. PLoS One 2023; 18:e0285395. [PMID: 37390066 PMCID: PMC10313032 DOI: 10.1371/journal.pone.0285395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 04/24/2023] [Indexed: 07/02/2023] Open
Abstract
BACKGROUND Stepped and Collaborative Care Models (SCCMs) have shown potential for improving mental health care. Most SCCMs have been used in primary care settings. At the core of such models are initial psychosocial distress assessments commonly in form of patient screening. We aimed to assess the feasibility of such assessments in a general hospital setting in Switzerland. METHODS We conducted and analyzed eighteen semi-structured interviews with nurses and physicians involved in a recent introduction of a SCCM model in a hospital setting, as part of the SomPsyNet project in Basel-Stadt. Following an implementation research approach, we used the Tailored Implementation for Chronic Diseases (TICD) framework for analysis. The TICD distinguishes seven domains: guideline factors, individual healthcare professional factors, patient factors, professional interactions, incentives and resources, capacity for organizational change, and social, political, and legal factors. Domains were split into themes and subthemes, which were used for line-by-line coding. RESULTS Nurses and physicians reported factors belonging to all seven TICD domains. An appropriate integration of the psychosocial distress assessment into preexisting hospital processes and information technology systems was the most important facilitator. Subjectivity of the assessment, lack of awareness about the assessment, and time constraints, particularly among physicians, were factors undermining and limiting the implementation of the psychosocial distress assessment. CONCLUSIONS Awareness raising through regular training of new employees, feedback on performance and patient benefits, and working with champions and opinion leaders can likely support a successful implementation of routine psychosocial distress assessments. Additionally, aligning psychosocial distress assessments with workflows is essential to assure the sustainability of the procedure in a working context with commonly limited time.
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Affiliation(s)
- Nicola Julia Aebi
- Swiss Center for International Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Iris Baenteli
- Department of Psychosomatic Medicine, University Hospital and University of Basel, Basel, Switzerland
| | - Günther Fink
- University of Basel, Basel, Switzerland
- Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
| | - Gunther Meinlschmidt
- Department of Psychosomatic Medicine, University Hospital and University of Basel, Basel, Switzerland
- Division of Clinical Psychology and Cognitive Behavioural Therapy, International Psychoanalytic University Berlin, Berlin, Germany
- Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland
| | - Rainer Schaefert
- Department of Psychosomatic Medicine, University Hospital and University of Basel, Basel, Switzerland
| | | | - Anja Studer
- Division of Prevention, Department of Health Canton Basel-Stadt, Basel, Switzerland
| | - Sarah Trost
- Department of Geriatric Medicine FELIX PLATTER, Basel, Switzerland
| | - Sibil Tschudin
- Department of Obstetrics and Gynecology, University Hospital and University of Basel, Basel, Switzerland
| | - Kaspar Wyss
- Swiss Center for International Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
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Hittle BM, Hils J, Fendinger SL, Wong IS. A scoping review of sleep education and training for nurses. Int J Nurs Stud 2023; 142:104468. [PMID: 37080122 PMCID: PMC10180237 DOI: 10.1016/j.ijnurstu.2023.104468] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 02/07/2023] [Accepted: 02/10/2023] [Indexed: 02/23/2023]
Abstract
BACKGROUND Shift work and resulting sleep impairment among nurses can increase their risk for poor health outcomes, occupational injuries, and errors due to sleep deficiencies. While sleep education and training for nurses has been recommended as part of a larger fatigue risk management system, little is known about training programs designed specifically for nurses. OBJECTIVE Investigate the literature for current sleep education or training programs specifically for shift working nurses, with intent to assess training content, delivery characteristics, and outcome measures. DESIGN A scoping review conducted October 2020 through September 2021. METHODS The bibliographic databases Cumulative Index of Nursing and Allied Health (CINAHL), Scopus, PubMed, and NIOSHTIC-2 were searched using words such as "nurse," "sleep hygiene," "shift work," and "education". Studies were included if they: 1) were original research; 2) discussed sleep education, training, or sleep hygiene interventions; 3) included a study population of nurses engaging in shift work; 4) focused on sleep as a primary study measure; 5) were written in English language; and 6) were published in 2000 or later. RESULTS Search results included 17,237 articles. After duplicates were removed, 14,620 articles were screened. Nine articles were found to meet established criteria. All studies included sleep hygiene content in the training programs, with five studies adding psychological and/or behavior change motivation training to support change in nurse sleep habits. Three studies added specific training for nurses and for managers. Delivery modes included in-person training of various lengths and frequency, mobile phone application with daily engagement, an online self-guided presentation, and daily reading material coupled with audio training. Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale were the outcome measures most frequently used. Although studies demonstrated improved sleep measures, most were pilot studies testing feasibility. CONCLUSION Although there is a paucity of studies focused on sleep education and training for shift working nurses, we found the inclusion of sleep hygiene content was the only common characteristic of all nine studies. The variability in training content, delivery methods, and outcome measures suggests further research is needed on what constitutes effective sleep education and training for nurses.
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Affiliation(s)
- Beverly M Hittle
- Division of Science Integration, National Institute for Occupational Safety and Health, Centers, for Disease Control and Prevention, 1090 Tusculum Ave, Cincinnati, OH 45226, USA; University of Cincinnati, College of Nursing, 3110 Vine St, Cincinnati, OH 45219, USA.
| | - Janie Hils
- Division of Science Integration, National Institute for Occupational Safety and Health, Centers, for Disease Control and Prevention, 1090 Tusculum Ave, Cincinnati, OH 45226, USA; Oak Ridge Institute for Science and Education, P.O. Box 117, Oak Ridge, TN 37830, USA; Division of Environmental Health Science and Practice, National Center for Environmental, Health, Centers for Disease Control and Prevention. Mailstop S106-5, 4770 Buford Highway, Atlanta, GA 30341, USA.
| | - Sherry L Fendinger
- Division of Science Integration, National Institute for Occupational Safety and Health, Centers, for Disease Control and Prevention, 1090 Tusculum Ave, Cincinnati, OH 45226, USA.
| | - Imelda S Wong
- Division of Science Integration, National Institute for Occupational Safety and Health, Centers, for Disease Control and Prevention, 1090 Tusculum Ave, Cincinnati, OH 45226, USA.
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Health Promotion for Outpatient Careworkers in Germany. Healthcare (Basel) 2022; 10:healthcare10061148. [PMID: 35742199 PMCID: PMC9223166 DOI: 10.3390/healthcare10061148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/03/2022] [Accepted: 06/10/2022] [Indexed: 11/17/2022] Open
Abstract
Due to ongoing demographic changes, the need for care is increasing in Germany. The number of outpatient care services is also rising, and with it, the number of employees in outpatient care, who are also continuously becoming older. Workplace health promotion (WHP) becomes relevant in this context, as it can reduce negative strain reactions and promote employees’ health. The aim of this study was (1) to reveal implemented WHP interventions in German outpatient care services; (2) to examine the potential challenges regarding a successful implementation of WHP measures; and (3) to illuminate further requests and needs experienced by outpatient careworkers. In qualitative field research, 30 semi-structured individual interviews were conducted with German caregivers, using the problem-centered interview method. The collected data were deductively and inductively evaluated and interpreted, using qualitative content analysis according to Mayring. Outpatient caregivers reported various WHP measures known from their workplaces, such as the provision of fruit baskets, programmes to increase physical activity, or a subsidy for a personal gym. They further reported WHP, such as back training, known from other care services. However, the respondents spoke of the challenges regarding the implementation or the use of WHP interventions in general. The most frequently named barriers were a lack of time after work and interventions that were only offered in their leisure time. In the same course, the participants still needed offers to increase physical activity, joint activities, or relaxation techniques. However, respondents highlighted that they preferred the interventions to take place during working hours. This way, they would also be more likely to take advantage of the interventions. The results of this study provide an insight into various WHP measures that already exist, or that are desirable for implementation with regard to caregivers’ needs. Subjectively perceived challenges for a successful implementation of WHP measures represent the importance of adjustments in the work organization of caregivers. It becomes clear that WHP is not yet established in the ambulant care sector, although it appears to be imperative for keeping caregivers healthy. Considering the different needs of employees, the results can provide a basis for the development of needs-based health promotion measures for caregivers.
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Schwatka NV, Dally M, Shore E, Tenney L, Brown CE, Scott JG, Dexter L, Newman LS. Small + Safe + Well: lessons learned from a Total Worker Health® randomized intervention to promote organizational change in small business. BMC Public Health 2022; 22:1039. [PMID: 35610627 PMCID: PMC9128251 DOI: 10.1186/s12889-022-13435-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 05/11/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Leadership commitment to worker safety and health is one of the most important factors when organizations develop and implement a Total Worker Health® approach. We aimed to assess the effectiveness of a Total Worker Health ("TWH") leadership development program that targeted owners and other senior-level leadership positions on changing organizational and worker outcomes from baseline to one-year later. METHODS The Small + Safe + Well study included small businesses from a variety of industries in the state of Colorado, USA that were participating in Health Links™. We designed a randomized waitlisted control comparison design (RCT) to evaluate the added benefit of a TWH leadership development program. An employer assessment tool was used to assess TWH policies and programs, and an employee health and safety survey was used to assess safety leadership and health leadership practices, safety climate and health climate, safety behaviors and health behaviors, and well-being. We used a linear mixed model framework with random effects for business and employee to assess the impact of intervention on the outcomes of interest. RESULTS Thirty-six businesses (37% retention) and 250 employees (9% retention) met the RCT study inclusion criteria and were included in the analysis. Businesses improved their TWH policies and programs score from baseline to one-year later, regardless of leadership intervention group assignment. Neither intervention group demonstrated improvements in employee-reported outcomes. CONCLUSIONS This study sought to address a gap in the literature regarding small business senior leadership development for TWH. Our study demonstrates many of the challenges of conducting studies focused on organizational change in workplaces, specifically in small businesses. When designing TWH intervention studies, researchers should consider how to best engage small business leaders in interventions and implementations early on, as well as methods that are well matched to measuring primary and secondary outcomes longitudinally. Future research is needed to test the feasibility and sustainability of TWH interventions in small business. TRIAL REGISTRATION The trial was retrospectively registered with ClinicalTrials.gov ( ID U19OH011227 ).
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Affiliation(s)
- Natalie V Schwatka
- Center for Health, Work & Environment, Colorado School of Public Health, Anschutz Medical Campus, University of Colorado, 13001 E. 17th Pl., 3rd Floor, Mail Stop B119 HSC, Aurora, CO, 80045, USA.
- Department of Environmental and Occupational Health, Colorado School of Public Health, Anschutz Medical Campus, University of Colorado, 13001 E. 17th Pl., 3rd Floor, Mail Stop B119 HSC, Aurora, CO, 80045, USA.
| | - Miranda Dally
- Center for Health, Work & Environment, Colorado School of Public Health, Anschutz Medical Campus, University of Colorado, 13001 E. 17th Pl., 3rd Floor, Mail Stop B119 HSC, Aurora, CO, 80045, USA
- Department of Environmental and Occupational Health, Colorado School of Public Health, Anschutz Medical Campus, University of Colorado, 13001 E. 17th Pl., 3rd Floor, Mail Stop B119 HSC, Aurora, CO, 80045, USA
| | - Erin Shore
- Center for Health, Work & Environment, Colorado School of Public Health, Anschutz Medical Campus, University of Colorado, 13001 E. 17th Pl., 3rd Floor, Mail Stop B119 HSC, Aurora, CO, 80045, USA
- Present Address: University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Liliana Tenney
- Center for Health, Work & Environment, Colorado School of Public Health, Anschutz Medical Campus, University of Colorado, 13001 E. 17th Pl., 3rd Floor, Mail Stop B119 HSC, Aurora, CO, 80045, USA
- Department of Environmental and Occupational Health, Colorado School of Public Health, Anschutz Medical Campus, University of Colorado, 13001 E. 17th Pl., 3rd Floor, Mail Stop B119 HSC, Aurora, CO, 80045, USA
| | - Carol E Brown
- Center for Health, Work & Environment, Colorado School of Public Health, Anschutz Medical Campus, University of Colorado, 13001 E. 17th Pl., 3rd Floor, Mail Stop B119 HSC, Aurora, CO, 80045, USA
| | - Joshua G Scott
- Center for Health, Work & Environment, Colorado School of Public Health, Anschutz Medical Campus, University of Colorado, 13001 E. 17th Pl., 3rd Floor, Mail Stop B119 HSC, Aurora, CO, 80045, USA
- Present Address: 2U, Inc., Lanham, MD, USA
| | - Lynn Dexter
- Center for Health, Work & Environment, Colorado School of Public Health, Anschutz Medical Campus, University of Colorado, 13001 E. 17th Pl., 3rd Floor, Mail Stop B119 HSC, Aurora, CO, 80045, USA
| | - Lee S Newman
- Center for Health, Work & Environment, Colorado School of Public Health, Anschutz Medical Campus, University of Colorado, 13001 E. 17th Pl., 3rd Floor, Mail Stop B119 HSC, Aurora, CO, 80045, USA
- Department of Environmental and Occupational Health, Colorado School of Public Health, Anschutz Medical Campus, University of Colorado, 13001 E. 17th Pl., 3rd Floor, Mail Stop B119 HSC, Aurora, CO, 80045, USA
- Department of Epidemiology, Colorado School of Public Health, and Department of Medicine, School of Medicine, Anschutz Medical Campus, University of Colorado, 13001 E. 17th Pl., 3rd Floor, Mail Stop B119 HSC, Aurora, CO, 80045, USA
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Factors Influencing Long-Term Care Workers' Self-Efficacy for Encouraging Residents to Engage in Physical Activity. J Aging Phys Act 2022; 30:987-994. [PMID: 35303711 DOI: 10.1123/japa.2021-0299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 02/08/2022] [Accepted: 02/09/2022] [Indexed: 11/18/2022]
Abstract
We aimed to assess work-related factors and their association with long-term care workers' self-efficacy for encouraging and engaging residents in physical activity. Baseline data from a worksite wellness study with 98 workers were used. We used a linear regression model, to assess if job satisfaction, work ability, and social support for staff health behaviors from coworkers and supervisors were associated with staffs' self-efficacy for Function-Focused Care (FFC) and Staffs' Outcome Expectations for FFC. Staffs' social support for healthy behaviors from coworkers was the only factor that was significantly associated with Staffs' Outcome Expectations for FFC and staffs' self-efficacy-FFC, respectively explaining 19% and 14% of the variance. Our findings show that staffs' social support from coworkers is associated with higher self-efficacy for encouraging and engaging residents in physical activity suggests future worksite wellness studies with long-term care workers may wish to consider assessing program impacts on residents' physical activity levels.
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Buchbinder M, Berlinger N, Jenkins TM. Protecting Practitioners in Stressed Systems: Translational Bioethics and the COVID-19 Pandemic. PERSPECTIVES IN BIOLOGY AND MEDICINE 2022; 65:637-645. [PMID: 36468392 PMCID: PMC10765946 DOI: 10.1353/pbm.2022.0055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
COVID-19 revealed health-care systems in crisis. Intersecting crises of stress, overwork, and poor working conditions have led to workforce strain, under-staffing, and high rates of job turnover. Bioethics researchers have responded to these conditions by investigating the ethical challenges of pandemic response for individuals, institutions, and health systems. This essay draws on pandemic findings to explore how empirical bioethics can inform post-pandemic translational bioethics. Borrowing from the concept of translational science in medicine, this essay proposes that translational bioethics should communicate knowledge about ethical challenges in health-care work to support health systems change. The authors draw from their experience with the Study to Examine Physicians' Pandemic Stress (STEPPS), an interdisciplinary research project that investigates physicians' experiences at the front lines of the COVID-19 pandemic. Using STEPPS as an example of empirical bioethics with potential for translation, the authors review their research and discuss the ongoing process for translating their findings, focusing on how bioethics research and practice can contribute to supporting the health-care workforce.
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Affiliation(s)
- Mara Buchbinder
- Department of Social Medicine and Center for Bioethics, University of North Carolina, Chapel Hill
| | | | - Tania M. Jenkins
- Department of Sociology, University of North Carolina, Chapel Hill
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Neumann FA, Rohwer E, Mojtahedzadeh N, Makarova N, Nienhaus A, Harth V, Augustin M, Mache S, Zyriax BC. Workplace Health Promotion and COVID-19 Support Measures in Outpatient Care Services in Germany: A Quantitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:12119. [PMID: 34831875 PMCID: PMC8620567 DOI: 10.3390/ijerph182212119] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 11/15/2021] [Accepted: 11/16/2021] [Indexed: 11/16/2022]
Abstract
Working conditions in the care sector, especially under the increased strain during COVID-19, make it difficult for outpatient caregivers to adhere to health-promoting behaviours. Research on workplace health promotion (WHP) and COVID-19 support measures in outpatient care services is limited. The aim of this pilot study was to characterise the current situation of WHP and COVID-19 support measures in outpatient care services and to explore how to offer WHP support measures targeted for a specific group. A web-based cross-sectional survey was conducted with outpatient caregivers (N = 171) in northern Germany. The results showed that 60.2% of the study participants were offered WHP support measures, with significantly higher work engagement when WHP support measures were available (Z = 4279.50, p < 0.01) and that 77.2% received specific support from their employer during the COVID-19 pandemic. Although spending a break in a break room was significantly associated with longer breaks as compared with being in a car (Z = 39.10, padj. = 0.01), a break room was neither available in all outpatient care services, nor did it appear to be feasible. Overall, WHP in outpatient care services is insufficiently covered. In order to be able to offer WHP support measures that are targeted to outpatient caregivers, cooperation among local care services, feasibility, and digital measures should be examined.
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Affiliation(s)
- Felix Alexander Neumann
- Midwifery Science—Health Services Research and Prevention, Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Martinistr. 52, 20246 Hamburg, Germany; (E.R.); (N.M.); (B.-C.Z.)
| | - Elisabeth Rohwer
- Midwifery Science—Health Services Research and Prevention, Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Martinistr. 52, 20246 Hamburg, Germany; (E.R.); (N.M.); (B.-C.Z.)
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), Seewartenstr. 10, 20459 Hamburg, Germany; (N.M.); (V.H.); (S.M.)
| | - Natascha Mojtahedzadeh
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), Seewartenstr. 10, 20459 Hamburg, Germany; (N.M.); (V.H.); (S.M.)
| | - Nataliya Makarova
- Midwifery Science—Health Services Research and Prevention, Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Martinistr. 52, 20246 Hamburg, Germany; (E.R.); (N.M.); (B.-C.Z.)
| | - Albert Nienhaus
- Department of Occupational Medicine, Hazardous Substances and Public Health, Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW), Pappelallee 33/35/37, 22089 Hamburg, Germany;
- Competence Center for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Martinistr. 52, 20246 Hamburg, Germany
| | - Volker Harth
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), Seewartenstr. 10, 20459 Hamburg, Germany; (N.M.); (V.H.); (S.M.)
| | - Matthias Augustin
- Competence Center for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Martinistr. 52, 20246 Hamburg, Germany;
| | - Stefanie Mache
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), Seewartenstr. 10, 20459 Hamburg, Germany; (N.M.); (V.H.); (S.M.)
| | - Birgit-Christiane Zyriax
- Midwifery Science—Health Services Research and Prevention, Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Martinistr. 52, 20246 Hamburg, Germany; (E.R.); (N.M.); (B.-C.Z.)
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Sorensen G, Peters SE, Nielsen K, Stelson E, Wallace LM, Burke L, Nagler EM, Roodbari H, Karapanos M, Wagner GR. Implementation of an organizational intervention to improve low-wage food service workers' safety, health and wellbeing: findings from the Workplace Organizational Health Study. BMC Public Health 2021; 21:1869. [PMID: 34656090 PMCID: PMC8520284 DOI: 10.1186/s12889-021-11937-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 10/05/2021] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Many organizational interventions aim to improve working conditions to promote and protect worker safety, health, and well-being. The Workplace Organizational Health Study used process evaluation to examine factors influencing implementation of an organizational intervention. This paper examines the extent to which the intervention was implemented as planned, the dose of intervention implemented, and ways the organizational context hindered or facilitated the implementation of the intervention. METHODS This proof-of-concept trial was conducted with a large, multinational company that provides food service through contractual arrangements with corporate clients. The 13-month intervention was launched in five intervention sites in October 2018. We report findings on intervention implementation based on process tracking and qualitative data. Qualitative data from 25 post-intervention interviews and 89 process tracking documents were coded and thematically analyzed. RESULTS Over the 13-month intervention, research team representatives met with site managers monthly to provide consultation and technical assistance on safety and ergonomics, work intensity, and job enrichment. Approximately two-thirds of the planned in-person or phone contacts occurred. We tailored the intervention to each site as we learned more about context, work demands, and relationships. The research team additionally met regularly with senior leadership and district managers, who provided corporate resources and guidance. By assessing the context of the food service setting in which the intervention was situated, we explored factors hindering and facilitating the implementation of the intervention. The financial pressures, competing priorities and the fast-paced work environment placed constraints on site managers' availability and limited the full implementation of the intervention. CONCLUSIONS Despite strong support from corporate senior leadership, we encountered barriers in the implementation of the planned intervention at the worksite and district levels. These included financial demands that drove work intensity; turnover of site and district managers disrupting continuity in the implementation of the intervention; and staffing constraints that further increased the work load and pace. Findings underscore the need for ongoing commitment and support from both the parent employer and the host client. TRIAL REGISTRATION This study was retrospectively registered with the Clinical Trials. Gov Protocol and Results System on June 2, 2021 with assigned registration number NCT04913168 .
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Affiliation(s)
- Glorian Sorensen
- Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA, 02215, USA.
- Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA.
| | - Susan E Peters
- Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA, 02215, USA
- Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA
| | - Karina Nielsen
- University of Sheffield, Conduit Rd, Sheffield, S10 1FL, UK
| | - Elisabeth Stelson
- Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA, 02215, USA
- Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA
| | | | - Lisa Burke
- Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA, 02215, USA
| | - Eve M Nagler
- Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA, 02215, USA
- Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA
| | - Hamid Roodbari
- University of Sheffield, Conduit Rd, Sheffield, S10 1FL, UK
| | - Melissa Karapanos
- Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA, 02215, USA
| | - Gregory R Wagner
- Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA
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Maglalang DD, Katigbak C, Gómez MAL, Sorensen G, Hopcia K, Hashimoto DM, Pandey S, Takeuchi DT, Sabbath EL. Workplace Discrimination and Short Sleep Among Healthcare Workers: The Buffering Effect of People-Oriented Culture. J Occup Environ Med 2021; 63:857-864. [PMID: 34597282 PMCID: PMC8486916 DOI: 10.1097/jom.0000000000002246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Examine the association of discrimination and short sleep and the buffering effect of people-oriented culture in the workplace among nurses and patient care associates. METHODS Used a mixed-methods design from the 2018 Boston Hospital Workers Health Study (N = 845) and semi-structured interviews among nurse directors (N = 16). RESULTS We found that people-oriented culture reduced the odds of short sleep and slightly attenuated the association of discrimination and short sleep. People-oriented culture did not buffer the effects of discrimination on short sleep. Qualitative findings showed that discrimination occurred between co-workers in relation to their job titles and existing support in the workplace does not address discrimination. CONCLUSIONS Healthcare industries need to implement specific programs and services aimed at addressing discrimination which can potentially improve health outcomes among workers.
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Affiliation(s)
- Dale Dagar Maglalang
- Stanford Prevention Research Center, Stanford University, School of Medicine, Stanford, California, USA
| | - Carina Katigbak
- Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts, USA
| | - María Andrée López Gómez
- Department of Sociology, Memorial University of Newfoundland, St. Johns, Newfoundland and Labrador, Canada
| | - Glorian Sorensen
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Karen Hopcia
- Workplace Health and Wellbeing, Partners HealthCare System, Boston, Massachusetts, USA
| | - Dean M. Hashimoto
- Workplace Health and Wellbeing, Partners HealthCare System, Boston, Massachusetts, USA
- Boston College Law School, Newton Centre, Massachusetts, USA
| | - Shanta Pandey
- School of Social Work, Boston College, Chestnut Hill, Massachusetts, USA
| | - David T. Takeuchi
- School of Social Work, University of Washington, Seattle, Washington, USA
| | - Erika L. Sabbath
- School of Social Work, Boston College, Chestnut Hill, Massachusetts, USA
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11
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Markkanen P, Peters SE, Grant M, Dennerlein JT, Wagner GR, Burke L, Wallace L, Sorensen G. Development and application of an innovative instrument to assess work environment factors for injury prevention in the food service industry. Work 2021; 68:641-651. [PMID: 33612509 DOI: 10.3233/wor-203399] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND With the growth the food service industry and associated high injury and illness rates, there is a need to assess workplace factors that contribute to injury prevention. OBJECTIVE The objective of this report is to describe the development, application, and utility of a new instrument to evaluate ergonomics and safety for food service workers. METHODS Starting with a similar tool developed for use in healthcare, a new tool was designed through a collaborative, participatory process with the stakeholders from a collaborating food service company. The new instrument enables the identification and assessment of key safety and health factors through a focused walkthrough of the physical work environment, and structured interviews exploring the organizational work environment. The researchers applied the instrument at 10 of the partnering company's worksites. RESULTS The instrument identified factors related to both the physical work environment and organizational and contextual environment (e.g., vendor-client relationships) impacting worker safety and health. CONCLUSIONS Modern assessment approaches should address both the physical and organizational aspects of the work environment, and consider the context complexities in which the worksites and the industry operate.
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Affiliation(s)
- Pia Markkanen
- Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, MA, USA
| | - Susan E Peters
- Dana Farber Cancer Institute, Boston, MA, USA.,Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, USA
| | - Michael Grant
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH, USA
| | - Jack T Dennerlein
- Department of Physical Therapy, Movement and Rehabilitation Sciences, Bouvé College of Health Sciences, Northeastern University, Boston MA, USA.,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Gregory R Wagner
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Lisa Burke
- Dana Farber Cancer Institute, Boston, MA, USA
| | | | - Glorian Sorensen
- Dana Farber Cancer Institute, Boston, MA, USA.,Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, USA
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12
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López Gómez MA, Gundersen DA, Boden LI, Sorensen G, Katz JN, Collins JE, Wagner G, Vriniotis MG, Williams JA. Validation of the Workplace Integrated Safety and Health (WISH) assessment in a sample of nursing homes using Item Response Theory (IRT) methods. BMJ Open 2021; 11:e045656. [PMID: 34145013 PMCID: PMC8215260 DOI: 10.1136/bmjopen-2020-045656] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 05/27/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To validate and test the dimensionality of six constructs from the Workplace Integrated Safety and Health (WISH) assessment, an instrument that assesses the extent to which organisations implement integrated systems approaches for protecting and promoting worker health, safety and well-being, in a sample of nursing homes in the USA. DESIGN Validation of an assessment scale using data from a cross-sectional survey. SETTING Nursing homes certified by the Centers for Medicaid and Medicare services in three states of the USA: Ohio, California and Massachusetts. PARTICIPANTS 569 directors of nursing from nursing homes serving adults and with more than 30 beds participated in the study. RESULTS Graded response Item Response Theory (IRT) models showed that five out of six constructs were unidimensional based on balanced interpretation of model fit statistics-M2 or C2 with p value >0.05, Comparative Fit Index >0.95, lower bound of the root mean squared error of approximation 90% CI <0.06 and standardised root mean square residual <0.08. Overall measure and construct reliability ranged from acceptable to good. Category boundary location parameters indicated that items were most informative for respondents in lower range of latent scores (ie, β1, β2, β3 typically below 0). A few items were recommended to be dropped from future administrations of the instrument based on empirical and substantive interpretation. CONCLUSIONS The WISH instrument has utility to understand to what extent organisations integrate protection and promotion of worker health, safety and well-being; however, it is most informative in organisations that present lower scores.
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Affiliation(s)
- María Andrée López Gómez
- Center for Work, Health and Well-being, Harvard University T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Daniel A Gundersen
- Survey and Data Management Core, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Leslie I Boden
- Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Glorian Sorensen
- Center for Work, Health and Well-being, Harvard University T. H. Chan School of Public Health, Boston, Massachusetts, USA
- Social and Behavioral Sciences, Harvard University T. H. Chan School of Public Health, Boston, Massachusetts, USA
- Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Jeffrey N Katz
- Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Jamie E Collins
- Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Gregory Wagner
- Center for Work, Health and Well-being, Harvard University T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Mary G Vriniotis
- Center for Work, Health and Well-being, Harvard University T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Jessica Ar Williams
- Health Policy and Management, University of Kansas School of Medicine, Kansas City, Kansas, USA
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13
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Daniels K, Watson D, Nayani R, Tregaskis O, Hogg M, Etuknwa A, Semkina A. Implementing practices focused on workplace health and psychological wellbeing: A systematic review. Soc Sci Med 2021; 277:113888. [PMID: 33865095 DOI: 10.1016/j.socscimed.2021.113888] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 01/21/2021] [Accepted: 03/27/2021] [Indexed: 02/08/2023]
Abstract
RATIONALE Workplace health and wellbeing practices (WHWPs) often fail to improve psychological health or wellbeing because of implementation failure. Thus, implementation should be evaluated to improve the effectiveness of WHWPs. OBJECTIVE We conducted a systematic review to identify critical success factors for WHWP implementation and gaps in the evidence. Doing so provides a platform for future theoretical development. METHODS We reviewed 74 separate studies that assessed the implementation of WHWPs and their effects on psychological health or psychological wellbeing. Most studies were from advanced industrial Western democracies (71). Intervention types included primary (e.g., work redesign, 37 studies; and health behavior change, 8 studies), secondary (e.g., mindfulness training, 11 studies), tertiary (e.g., focused on rehabilitation, 9 studies), and multifocal (e.g., including components of primary and secondary, 9 studies). RESULTS Tangible changes preceded improvements in health and wellbeing, indicating intervention success cannot be attributed to non-specific factors. Some interventions had beneficial effects through mechanisms not planned as part of the intervention. Three factors were associated with successful WHWP implementation: continuation, learning, and effective governance. CONCLUSIONS The review indicates future research could focus on how organizations manage conflict between WHWP implementation and existing organizational processes, and the dynamic nature of organizational contexts that affect and are affected by WHWP implementation. This systematic review is registered [PROSPERO: the International Prospective Register of Systematic Reviews ID: CRD42019119656].
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Affiliation(s)
- Kevin Daniels
- Employment Systems and Institutions Group, Norwich Business School, University of East Anglia, NR4 7TJ, United Kingdom.
| | - David Watson
- Employment Systems and Institutions Group, Norwich Business School, University of East Anglia, NR4 7TJ, United Kingdom
| | - Rachel Nayani
- Employment Systems and Institutions Group, Norwich Business School, University of East Anglia, NR4 7TJ, United Kingdom
| | - Olga Tregaskis
- Employment Systems and Institutions Group, Norwich Business School, University of East Anglia, NR4 7TJ, United Kingdom
| | - Martin Hogg
- Employment Systems and Institutions Group, Norwich Business School, University of East Anglia, NR4 7TJ, United Kingdom
| | - Abasiama Etuknwa
- Employment Systems and Institutions Group, Norwich Business School, University of East Anglia, NR4 7TJ, United Kingdom
| | - Antonina Semkina
- Employment Systems and Institutions Group, Norwich Business School, University of East Anglia, NR4 7TJ, United Kingdom
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14
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Ensuring Organization-Intervention Fit for a Participatory Organizational Intervention to Improve Food Service Workers' Health and Wellbeing: Workplace Organizational Health Study. J Occup Environ Med 2021; 62:e33-e45. [PMID: 31815814 DOI: 10.1097/jom.0000000000001792] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Food-service workers' health and wellbeing is impacted by their jobs and work environments. Formative research methods were used to explore working conditions impacting workers' health to inform intervention planning and implementation and to enhance the intervention's "fit" to the organization. METHODS Four qualitative methods (worker focus groups; manager interviews; worksite observations; multi-stakeholder workshop) explored in-depth and then prioritized working conditions impacting workers' health as targets for an intervention. RESULTS Prioritized working conditions included: ergonomics; work intensity; career development; and job enrichment. Data revealed necessary intervention mechanisms to enhance intervention implementation: worker and management communication infrastructure; employee participation in intervention planning and implementation; tailored worksite strategies; and ensuring leadership commitment. CONCLUSIONS These targeted, comprehensive methods move away from a typical focus on generic working conditions, for example, job demands and physical work environment, to explore those conditions unique to an organization. Thereby, enhancing "intervention-fit" at multiple levels within the company context.
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15
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Doran K, Collado A, Taylor H, Felton JW, Tormohlen KN, Yi R. Methods to Optimize Recruitment, Participation, and Retention Among Vulnerable Individuals Participating in a Longitudinal Clinical Trial. Res Theory Nurs Pract 2021; 35:24-49. [PMID: 33632921 DOI: 10.1891/rtnp-d-19-00039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Low-income and ethnic/racial minority adults do not often participate in research or may face unique barriers when participating in research, which delays and impedes medical advances for this vulnerable population. This article describes in detail the evidenced-based methods used to enhance recruitment, participation, and retention in a clinical trial at a center serving ethnic/racial minorities and low-income individuals. The article details the partnership with a community outreach center and describes the duties and impact of a community liaison to enhance recruitment, participation, and retention in a randomized controlled trial with a 6-month follow-up. Of the 246 individuals initially recruited for screening, 80 did not meet inclusion criteria with the most common reason for disqualification being meeting criteria for substance use disorder (n = 44). One hundred sixty-six participants qualified for participation. The majority of participants identified as African American (n = 127, 77.1%) and reported an annual individual income under $10,000 (n = 121 (74.2%). Forty-five percent of the sample completed the requested number of sessions (i.e., 12). Sixty-three percent of participants completed post intervention assessments and 42% completed 6-month follow-up data collection. The participation and retention numbers in this study appear higher than typical participation and retention rates in longitudinal studies with similar populations. The methods and lessons learned may be useful for other clinical trials that recruit vulnerable populations and wish to enhance participation, engagement, and retention.
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Affiliation(s)
- Kelly Doran
- School of Nursing, University of Maryland, Baltimore, MD
| | - Anahi Collado
- Department of Psychology, University of Kansas, Lawrence, KS
| | - Hailey Taylor
- Department of Psychology, University of Kansas, Lawrence, KS
| | - Julia W Felton
- Division of Public Health, Michigan State University, Flint, MI
| | - Kayla N Tormohlen
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Richard Yi
- Department of Psychology, University of Kansas, Lawrence, KS
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16
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Mojtahedzadeh N, Neumann FA, Rohwer E, Augustin M, Zyriax BC, Harth V, Mache S. Betriebliche Gesundheitsförderung in der Pflege. PRAVENTION UND GESUNDHEITSFORDERUNG 2020. [DOI: 10.1007/s11553-020-00800-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Zusammenfassung
Hintergrund
In der Pflegebranche nehmen Arbeitsunfähigkeitstage durch verschiedene Fehlbelastungen zu, welches die Relevanz der Betrieblichen Gesundheitsförderung (BGF) hervorhebt.
Ziel der Arbeit
Der Artikel soll die Thematik der BGF in der Pflege beleuchten und zudem eine Übersicht von bestehenden betrieblichen Gesundheitsförderungsmaßnahmen im Setting Pflege bieten.
Material und Methoden
In einer explorativen Literaturrecherche werden bisher verfügbare Erkenntnisse aus der BGF in der Pflege recherchiert und zusammengefasst. Aus diesen Forschungserkenntnissen werden Maßnahmenvorschläge für die Pflege-BGF abgeleitet. Die Vorschläge sollten aktualisiert werden, wenn derzeit laufende arbeitspsychologische Studien neue Erkenntnisse hervorgebracht haben.
Ergebnisse
Bestehende Interventionen in der Pflegebranche, welche beispielsweise Achtsamkeitstrainings, Maßnahmen zur Stress‑/Tabakkonsumreduzierung sowie die Förderung gesunder Ernährungsweise und körperlichen Aktivität beinhalten, werden dargestellt.
Diskussion
Studienergebnisse zeigen, dass Interventionen zur Stressreduzierung aus der stationären Pflege effektiv das Stresserleben der Pflegekräfte senken konnten. Web-basierte Interventionen scheinen darüber hinaus für das ambulante Pflegesetting als erstrebenswert. Mögliche Herausforderungen, wie fehlende Fachkenntnisse und -kräfte, für die BGF-Umsetzung werden diskutiert.
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17
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Sabbath EL, Hashimoto D, Boden LI, Dennerlein JT, Williams JAR, Hopcia K, Orechia T, Tripodis Y, Stoddard A, Sorensen G. Cohort profile: The Boston Hospital Workers Health Study (BHWHS). Int J Epidemiol 2019; 47:1739-1740g. [PMID: 30107500 DOI: 10.1093/ije/dyy164] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2018] [Indexed: 12/18/2022] Open
Affiliation(s)
- Erika L Sabbath
- School of Social Work, Boston College, Chestnut Hill, MA, USA
| | - Dean Hashimoto
- Partners HealthCare, Boston, MA, USA.,School of Law, Boston College, Newton, MA, USA
| | - Leslie I Boden
- School of Public Health, Boston University, Boston, MA, USA
| | - Jack T Dennerlein
- Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA
| | | | | | | | | | - Anne Stoddard
- Centre for Community-based Research, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Glorian Sorensen
- Centre for Community-based Research, Dana-Farber Cancer Institute, Boston, MA, USA.,Department of Social and Behavioural Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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18
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Sabbath EL, Yang J, Dennerlein JT, Boden LI, Hashimoto D, Sorensen G. Paradoxical Impact of a Patient-Handling Intervention on Injury Rate Disparity Among Hospital Workers. Am J Public Health 2019; 109:618-625. [PMID: 30789763 DOI: 10.2105/ajph.2018.304929] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVES To test whether a comprehensive safe patient-handling intervention, which successfully reduced overall injury rates among hospital workers in a prior study, was differentially effective for higher-wage workers (nurses) versus low-wage workers (patient care associates [PCAs]). METHODS Data were from a cohort of nurses and PCAs at 2 large hospitals in Boston, Massachusetts. One hospital received the intervention in 2013; the other did not. Using longitudinal survey data from 2012 and 2014 plus longitudinal administrative injury and payroll data, we tested for socioeconomic differences in changes in self-reported safe patient-handling practices, and for socioeconomic differences in changes in injury rates using administrative data. RESULTS After the intervention, improvements in self-reported patient-handling practices were equivalent for PCAs and for nurses. However, in administrative data, lifting and exertion injuries decreased among nurses (rate ratio [RR] = 0.64; 95% confidence interval [CI] = 0.41, 1.00) but not PCAs (RR = 1.10; 95% CI = 0.74,1.63; P for occupation × intervention interaction = 0.02). CONCLUSIONS Although the population-level injury rate decreased after the intervention, most improvements were among higher-wage workers, widening the socioeconomic gap in injury and exemplifying the inequality paradox. Results have implications for public health intervention development, implementation, and analysis.
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Affiliation(s)
- Erika L Sabbath
- Erika L. Sabbath is with the School of Social Work, Boston College, Chestnut Hill, MA. At the time of the study, Jie Yang was with the School of Social Work, Boston College, and is also with the School of Social Work, East Carolina University, Greenville. Jack T. Dennerlein is with the Bouve College of Health Sciences, Northeastern University, Boston, MA. Leslie I. Boden is with the Department of Environmental Health, School of Public Health, Boston University, Boston. Dean Hashimoto is with Partners HealthCare, Somerville, MA. Glorian Sorensen is with the Center for Community-Based Research, Dana-Farber Cancer Institute, Boston
| | - Jie Yang
- Erika L. Sabbath is with the School of Social Work, Boston College, Chestnut Hill, MA. At the time of the study, Jie Yang was with the School of Social Work, Boston College, and is also with the School of Social Work, East Carolina University, Greenville. Jack T. Dennerlein is with the Bouve College of Health Sciences, Northeastern University, Boston, MA. Leslie I. Boden is with the Department of Environmental Health, School of Public Health, Boston University, Boston. Dean Hashimoto is with Partners HealthCare, Somerville, MA. Glorian Sorensen is with the Center for Community-Based Research, Dana-Farber Cancer Institute, Boston
| | - Jack T Dennerlein
- Erika L. Sabbath is with the School of Social Work, Boston College, Chestnut Hill, MA. At the time of the study, Jie Yang was with the School of Social Work, Boston College, and is also with the School of Social Work, East Carolina University, Greenville. Jack T. Dennerlein is with the Bouve College of Health Sciences, Northeastern University, Boston, MA. Leslie I. Boden is with the Department of Environmental Health, School of Public Health, Boston University, Boston. Dean Hashimoto is with Partners HealthCare, Somerville, MA. Glorian Sorensen is with the Center for Community-Based Research, Dana-Farber Cancer Institute, Boston
| | - Leslie I Boden
- Erika L. Sabbath is with the School of Social Work, Boston College, Chestnut Hill, MA. At the time of the study, Jie Yang was with the School of Social Work, Boston College, and is also with the School of Social Work, East Carolina University, Greenville. Jack T. Dennerlein is with the Bouve College of Health Sciences, Northeastern University, Boston, MA. Leslie I. Boden is with the Department of Environmental Health, School of Public Health, Boston University, Boston. Dean Hashimoto is with Partners HealthCare, Somerville, MA. Glorian Sorensen is with the Center for Community-Based Research, Dana-Farber Cancer Institute, Boston
| | - Dean Hashimoto
- Erika L. Sabbath is with the School of Social Work, Boston College, Chestnut Hill, MA. At the time of the study, Jie Yang was with the School of Social Work, Boston College, and is also with the School of Social Work, East Carolina University, Greenville. Jack T. Dennerlein is with the Bouve College of Health Sciences, Northeastern University, Boston, MA. Leslie I. Boden is with the Department of Environmental Health, School of Public Health, Boston University, Boston. Dean Hashimoto is with Partners HealthCare, Somerville, MA. Glorian Sorensen is with the Center for Community-Based Research, Dana-Farber Cancer Institute, Boston
| | - Glorian Sorensen
- Erika L. Sabbath is with the School of Social Work, Boston College, Chestnut Hill, MA. At the time of the study, Jie Yang was with the School of Social Work, Boston College, and is also with the School of Social Work, East Carolina University, Greenville. Jack T. Dennerlein is with the Bouve College of Health Sciences, Northeastern University, Boston, MA. Leslie I. Boden is with the Department of Environmental Health, School of Public Health, Boston University, Boston. Dean Hashimoto is with Partners HealthCare, Somerville, MA. Glorian Sorensen is with the Center for Community-Based Research, Dana-Farber Cancer Institute, Boston
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Wagner A, Rieger MA, Manser T, Sturm H, Hardt J, Martus P, Lessing C, Hammer A. Healthcare professionals' perspectives on working conditions, leadership, and safety climate: a cross-sectional study. BMC Health Serv Res 2019; 19:53. [PMID: 30665401 PMCID: PMC6341698 DOI: 10.1186/s12913-018-3862-7] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 12/27/2018] [Indexed: 03/19/2024] Open
Abstract
Background Promoting patient and occupational safety are two key challenges for hospitals. When aiming to improve these two outcomes synergistically, psychosocial working conditions, leadership by hospital management and supervisors, and perceptions of patient and occupational safety climate have to be considered. Recent studies have shown that these key topics are interrelated and form a critical foundation for promoting patient and occupational safety in hospitals. So far, these topics have mainly been studied independently from each other. The present study investigated hospital staffs’ perceptions of four different topics: (1) psychosocial working conditions, (2) leadership, (3) patient safety climate, and (4) occupational safety climate. We present results from a survey in two German university hospitals aiming to detect differences between nurses and physicians. Methods We performed a cross-sectional study using a standardized paper-based questionnaire. The survey was conducted with nurses and physicians to assess the four topics. The instruments mainly consisted of scales of the German version of the COPSOQ (Copenhagen Psychosocial Questionnaire), one scale of the Copenhagen Burnout Inventory (CBI), scales to assess leadership and transformational leadership, scales to assess patient safety climate using the Hospital Survey on Patient Safety Culture (HSPSC), and analogous items to assess occupational safety climate. Results A total of 995 completed questionnaires out of 2512 distributed questionnaires were returned anonymously. The overall response rate was 39.6%. The sample consisted of 381 physicians and 567 nurses. We found various differences with regard to the four topics. In most of the COPSOQ and the HSPSC-scales, physicians rated psychosocial working conditions and patient safety climate more positively than nurses. With regard to occupational safety, nurses indicated higher occupational risks than physicians. Conclusions The WorkSafeMed study combined the assessment of the four topics psychosocial working conditions, leadership, patient safety climate, and occupational safety climate in hospitals. Looking at the four topics provides an overview of where improvements in hospitals may be needed for nurses and physicians. Based on these results, improvements in working conditions, patient safety climate, and occupational safety climate are required for health care professionals in German university hospitals – especially for nurses. Electronic supplementary material The online version of this article (10.1186/s12913-018-3862-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Anke Wagner
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital of Tübingen, Wilhelmstraße 27, 72074, Tübingen, Germany.
| | - Monika A Rieger
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital of Tübingen, Wilhelmstraße 27, 72074, Tübingen, Germany
| | - Tanja Manser
- University of Applied Sciences and Arts Northwestern Switzerland, FHNW School of Applied Psychology, Riggenbachstrasse 16, 4600, Olten, Switzerland
| | - Heidrun Sturm
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital of Tübingen, Wilhelmstraße 27, 72074, Tübingen, Germany
| | - Juliane Hardt
- Institute for Clinical Epidemiology and Applied Biometry, University Hospital of Tübingen, Silcherstraße 5, 72076, Tübingen, Germany.,Berlin Institute of Health (BIH), Clinical Research Unit (CRU), Anna-Louisa-Karsch-Str. 2, 10178, Berlin, Germany.,Institute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Peter Martus
- Institute for Clinical Epidemiology and Applied Biometry, University Hospital of Tübingen, Silcherstraße 5, 72076, Tübingen, Germany
| | | | - Antje Hammer
- Institute for Patient Safety, University Hospital of Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany
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20
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Testing the Impact of the Worksite Heart Health Improvement Project on Cardiovascular Disease Risk Factors Over Time. J Occup Environ Med 2018; 60:717-723. [DOI: 10.1097/jom.0000000000001304] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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21
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Sabbath EL, Williams JA, Boden LI, Tempesti T, Wagner GR, Hopcia K, Hashimoto D, Sorensen G. Mental Health Expenditures: Association With Workplace Incivility and Bullying Among Hospital Patient Care Workers. J Occup Environ Med 2018; 60:737-742. [PMID: 29538275 PMCID: PMC6086762 DOI: 10.1097/jom.0000000000001322] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Bullied workers have poor self-reported mental health; monetary costs of bullying exposure are unknown. We tested associations between bullying and health plan claims for mental health diagnoses. METHODS We used data from 793 hospital workers who answered questions about bullying in a survey and subscribed to the group health plan. We used two-part models to test associations between types of incivility/bullying and mental health expenditures. RESULTS Workers experiencing incivility or bullying had greater odds of any mental health claims. Among claimants, unexposed workers spent $792, those experiencing one type of incivility or bullying spent $1557 (P for difference from unexposed = 0.016), those experiencing two types spent $928 (P = 0.503), and those experiencing three types spent $1446 (P = 0.040). CONCLUSION Workplace incivility and bullying may carry monetary costs to employers, which could be controlled through work environment modification.
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Affiliation(s)
| | | | | | | | | | | | - Dean Hashimoto
- Partners HealthCare System, Inc., Boston College Law School
| | - Glorian Sorensen
- Dana-Farber Cancer Institute Center for Community-based Research, Harvard T.H. Chan School of Public Health
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Sabbath EL, Sparer EH, Boden LI, Wagner GR, Hashimoto DM, Hopcia K, Sorensen G. Preventive care utilization: Association with individual- and workgroup-level policy and practice perceptions. Prev Med 2018; 111:235-240. [PMID: 29567439 PMCID: PMC6028933 DOI: 10.1016/j.ypmed.2018.03.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 02/05/2018] [Accepted: 03/14/2018] [Indexed: 01/13/2023]
Abstract
Preventive medical care may reduce downstream medical costs and reduce population burden of disease. However, although social, demographic, and geographic determinants of preventive care have been studied, there is little information about how the workplace affects preventive care utilization. This study examines how four types of organizational policies and practices (OPPs) are associated with individual workers' preventive care utilization. We used data collected in 2012 from 838 hospital patient care workers, grouped in 84 patient care units at two hospitals in Boston. Via survey, we assessed individuals' perceptions of four types of OPPs on their work units. We linked the survey data to a database containing detailed information on medical expenditures. Using multilevel models, we tested whether individual-level perceptions, workgroup-average perceptions, and their combination were associated with individual workers' preventive care utilization (measured by number of preventive care encounters over a two-year period). Adjusting for worker characteristics, higher individual-level perceptions of workplace flexibility were associated with greater preventive care utilization. Higher average unit-level perceptions of people-oriented culture, ergonomic practices, and flexibility were associated with greater preventive care utilization. Overall, we find that workplace policies and practices supporting flexibility, ergonomics, and people-oriented culture are associated with positive preventive care-seeking behavior among workers, with some policies and practices operating at the individual level and some at the group level. Improving the work environment could impact employers' health-related expenditures and improve workers' health-related quality of life.
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Affiliation(s)
- Erika L Sabbath
- Boston College, School of Social Work, Chestnut Hill, MA, United States.
| | - Emily H Sparer
- Center for Community-based Research, Dana-Farber Cancer Institute, Boston, MA, United States; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Leslie I Boden
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, United States
| | - Gregory R Wagner
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Dean M Hashimoto
- Workplace Health and Wellbeing, Partners HealthCare System, Boston, MA, United States; Boston College Law School, Chestnut Hill, MA, United States
| | - Karen Hopcia
- Workplace Health and Wellbeing, Partners HealthCare System, Boston, MA, United States
| | - Glorian Sorensen
- Center for Community-based Research, Dana-Farber Cancer Institute, Boston, MA, United States; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States
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Magnavita N. Medical Surveillance, Continuous Health Promotion and a Participatory Intervention in a Small Company. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E662. [PMID: 29614831 PMCID: PMC5923704 DOI: 10.3390/ijerph15040662] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 03/29/2018] [Accepted: 03/30/2018] [Indexed: 12/23/2022]
Abstract
The workplace is an ideal setting for health promotion. The regular medical examination of workers enables us to screen for numerous diseases, spread good practices and correct lifestyles, and obtain a favourable risk/benefit ratio. The continuous monitoring of the level of workers' wellbeing using a holistic approach during medical surveillance enables us to promptly identify problems in work organisation and the company climate. Problems of this kind can be adequately managed by using a participatory approach. The aim of this paper is twofold: to signal this way of proceeding with medical surveillance, and to describe an organisational development intervention. Participatory groups were used to improve occupational life in a small company. After intervention we observed a reduction in levels of perceived occupational stress measured with the Effort/Reward Imbalance questionnaire, and an improvement in psychological wellbeing assessed by means of the Goldberg Anxiety/Depression scale. Although the limited size of the sample and the lack of a control group call for a cautious evaluation of this study, the participatory strategy proved to be a useful tool due to its cost-effectiveness.
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Affiliation(s)
- Nicola Magnavita
- Institute of Public Health, Università Cattolica del Sacro Cuore, Roma, Italy.
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Abstract
Work participation is increasingly seen as a primary outcome of rehabilitation measures. Randomised controlled trials from several different countries and the reviews and meta-analyses based on them show that multidisciplinary rehabilitation programmes improve work participation, return-to-work rates, and reduce sickness absence in patients with back pain, depression, and cancer. In Germany, such programmes were implemented as work-related medical rehabilitation. This intervention targets patients with poor work ability and an increased risk of permanent work disability. Randomised controlled trials have confirmed a reduction of sickness absence and increased rates of sustainable work participation in favour of work-related medical rehabilitation as compared to common medical rehabilitation. Dissemination of these programmes and translation of research evidence into practice progresses. An additional important strategy to support returning to work following rehabilitation is graded return to work. There is emerging evidence of sustainable employment effects in favour of graded return to work. A direct involvement of the workplace and a closer cooperation with employers and occupational health physicians may further improve the outcomes of rehabilitation programmes. Strategies that synergistically integrate safety, health promotion and rehabilitation may achieve more favourable outcomes than separated actions.
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25
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Grant MP, Okechukwu CA, Hopcia K, Sorensen G, Dennerlein JT. An Inspection Tool and Process to Identify Modifiable Aspects of Acute Care Hospital Patient Care Units to Prevent Work-Related Musculoskeletal Disorders. Workplace Health Saf 2017; 66:144-158. [DOI: 10.1177/2165079917718852] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A dearth of practical resources is available for evaluating ergonomic risk factors in dynamic health care work environments. Of particular need are tools for inspecting patient care environments for hazards. The goal of this study was to describe the development and application of an inspection tool and a process for identifying hazards inherent in the modifiable aspects of the physical environment to reduce injury risk to hospital workers. Through an iterative and participatory process, the tool and inspection process were developed with three purposes in mind: (a) create a framework for the inspection of physical work environments and physical conditions of work associated with injury risk (hazards), (b) document the physical conditions, and (c) provide feedback to decision makers. The tool and process were used by an ergonomics researcher on four patient care units as part of the Be Well, Work Well Total Worker Health® intervention. The resulting inspection process provided a structured method for recognizing hazards in the dynamic modifiable physical work environment and reporting both observations and recommendations to decision makers. The development and implementation of the inspection tool provided guidance to modify the physical work environment by implementing ergonomic solutions. The tool allowed the organization to plan and prioritize ergonomic hazard abatement (e.g. resource allocation and tracking trends). Within a Total Worker Health® framework, this tool can measure work practices which can then be used to inform organizational programs and policies within a health care setting.
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26
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Abstract
Little is known about long-term care workers’ cardiovascular disease (CVD) risk. Thus, the authors used baseline objective and subjective data from 98 long-term care staff participating in a worksite health promotion study to provide a comprehensive CVD assessment. The median age of the sample was 32 years ( SD = 13.38). Nine (12.2%) participants smoked and 27 (37.0%) participants reported exposure to secondhand smoke. The average nightly hours of sleep was 6.5 ( SD = 1.18), with 24 (32%) participants reporting sleeping at least fairly bad. Sixty-eight participants (73.1%) were overweight or obese. The median aerobic activity was 0 ( SD = 18.56). Participants ate on average 27 ( SD = 17.34) servings of high fatty and/or salty foods per week. Although blood pressure and cholesterol levels were within normal limits, this population demonstrated poor behavioral CVD risk factors. Given this finding and the young age of the sample, these workers may be ideal candidates for health promotion efforts before health risk factors are present.
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Dennerlein JT, O'Day ET, Mulloy DF, Somerville J, Stoddard AM, Kenwood C, Teeple E, Boden LI, Sorensen G, Hashimoto D. Lifting and exertion injuries decrease after implementation of an integrated hospital-wide safe patient handling and mobilisation programme. Occup Environ Med 2016; 74:336-343. [PMID: 27919058 DOI: 10.1136/oemed-2015-103507] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 09/15/2016] [Accepted: 10/03/2016] [Indexed: 12/11/2022]
Abstract
OBJECTIVE With increasing emphasis on early and frequent mobilisation of patients in acute care, safe patient handling and mobilisation practices need to be integrated into these quality initiatives. We completed a programme evaluation of a safe patient handling and mobilisation programme within the context of a hospital-wide patient care improvement initiative that utilised a systems approach and integrated safe patient equipment and practices into patient care plans. METHODS Baseline and 12-month follow-up surveys of 1832 direct patient care workers assessed work practices and self-reported pain while an integrated employee payroll and injury database provided recordable injury rates collected concurrently at 2 hospitals: the study hospital with the programme and a comparison hospital. RESULTS Safe and unsafe patient handling practice scales at the study hospital improved significantly (p<0.0001 and p=0.0031, respectively), with no differences observed at the comparison hospital. We observed significant decreases in recordable neck and shoulder (Relative Risk (RR)=0.68, 95% CI 0.46 to 1.00), lifting and exertion (RR=0.73, 95% CI 0.60 to 0.89) and pain and inflammation (RR=0.78, 95% CI 0.62 to 1.00) injury rates at the study hospital. Changes in rates at the comparison hospital were not statistically significant. CONCLUSIONS Within the context of a patient mobilisation initiative, a safe patient handling and mobilisation programme was associated with improved work practices and a reduction in recordable worker injuries. This study demonstrates the potential impact of utilising a systems approach based on recommended best practices, including integration of these practices into the patient's plan for care.
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Affiliation(s)
- Jack T Dennerlein
- Department of Physical Therapy, Movement, and Rehabilitation Sciences, Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts, USA.,Department of Environmental Health and The Center for Work, Health, and Wellbeing, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Elizabeth Tucker O'Day
- Department of Occupational Health Services, Partners HealthCare System, Boston, Massachusetts, USA
| | - Deborah F Mulloy
- Center for Nursing Excellence, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Jackie Somerville
- Patient Care Services Center for Nursing Excellence, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Anne M Stoddard
- Center of Community Based Research, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | | | - Erin Teeple
- Department of Environmental Health and The Center for Work, Health, and Wellbeing, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.,Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Leslie I Boden
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Glorian Sorensen
- Center of Community Based Research, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Department of Social and Behavioral Sciences Health and The Center for Work, Health, and Wellbeing, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Dean Hashimoto
- Department of Occupational Health Services, Partners HealthCare System, Boston, Massachusetts, USA.,Boston College Law School, Newton Centre, Massachusetts, USA.,Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
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Sorensen G, McLellan DL, Sabbath EL, Dennerlein JT, Nagler EM, Hurtado DA, Pronk NP, Wagner GR. Integrating worksite health protection and health promotion: A conceptual model for intervention and research. Prev Med 2016; 91:188-196. [PMID: 27527576 PMCID: PMC5050152 DOI: 10.1016/j.ypmed.2016.08.005] [Citation(s) in RCA: 96] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 06/28/2016] [Accepted: 08/01/2016] [Indexed: 01/03/2023]
Abstract
There is increasing recognition of the value added by integrating traditionally separate efforts to protect and promote worker safety and health. This paper presents an innovative conceptual model to guide research on determinants of worker safety and health and to inform the design, implementation and evaluation of integrated approaches to promoting and protecting worker health. This model is rooted in multiple theories and the premise that the conditions of work are important determinants of individual safety and health outcomes and behaviors, and outcomes important to enterprises such as absence and turnover. Integrated policies, programs and practices simultaneously address multiple conditions of work, including the physical work environment and the organization of work (e.g., psychosocial factors, job tasks and demands). Findings from two recent studies conducted in Boston and Minnesota (2009-2015) illustrate the application of this model to guide social epidemiological research. This paper focuses particular attention on the relationships of the conditions of work to worker health-related behaviors, musculoskeletal symptoms, and occupational injury; and to the design of integrated interventions in response to specific settings and conditions of work of small and medium size manufacturing businesses, based on a systematic assessment of priorities, needs, and resources within an organization. This model provides an organizing framework for both research and practice by specifying the causal pathways through which work may influence health outcomes, and for designing and testing interventions to improve worker safety and health that are meaningful for workers and employers, and responsive to that setting's conditions of work.
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Affiliation(s)
- Glorian Sorensen
- Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA 02215, USA; Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA.
| | - Deborah L McLellan
- Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA 02215, USA; Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA
| | - Erika L Sabbath
- Boston College, School of Social Work, 140 Commonwealth Avenue, Chestnut Hill, MA 02467, USA
| | - Jack T Dennerlein
- Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA; Northeastern University, Bouvé College of Health Sciences, 360 Huntington Ave, Boston, MA, USA
| | - Eve M Nagler
- Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA 02215, USA; Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA
| | - David A Hurtado
- Oregon Institute of Occupational Health Science, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, L606, Portland, OR 97239, USA
| | - Nicolaas P Pronk
- Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA; HealthPartners, Inc., 8170 33rd Ave S, Bloomington, MN 55425, USA
| | - Gregory R Wagner
- Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA; National Institute for Occupational Safety and Health, 395 E Street, SW, Washington, DC 20201, USA
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