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Shah F, Sells JR, Werthman J, Abraham C, Ali AM, Callaway-Lane C. A Multi-Site Evaluation of A National Employee Wellness Initiative at the Department of Veterans Affairs. Glob Adv Health Med 2022; 11:21649561211053805. [PMID: 35273830 PMCID: PMC8902194 DOI: 10.1177/21649561211053805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/24/2021] [Accepted: 09/29/2021] [Indexed: 11/16/2022] Open
Abstract
Background The Department of Veterans Affairs (VA) seeks to transform its health care
delivery from disease-centered, episodic care to a holistic and
patient-centered model known as the Whole Health System (WHS) of care.
Employee engagement and buy-in are crucial to this cultural transformation.
The VA aspires to provide employees with opportunities to experience whole
health in their personal and professional lives through a national Employee
Whole Health (EWH) program. Although there are national recommendations,
different local facilities may have unique strategies and challenges as they
implement this program. Objective This study aimed to conduct a program evaluation of EWH at three different VA
facilities across the United States in order to identify facilitators and
barriers to the implementation of EWH. Methods The team used the RE-AIM framework to develop an interview guide to assess
various domains of implementation. Quantitative data on whole health
offerings at each site were gauged using a national employee education
platform. Standardized employee-related metrics at each site were assessed
using the annual, national VA employee survey. Results EWH has had variable implementation at the three sites. Sites noted main
facilitators as employee interest as well as available skills and expertise
for delivering complementary and integrative care to employees. Limited
staffing for EWH and a lack of dedicated employee time were cited as
barriers. The infrastructure to perform local program evaluations to
demonstrate effectiveness and impact were missing. Conclusion Employee engagement in whole health activities has the potential to support
the VA’s mission to transform its health care delivery model. Currently, the
use of EWH and its potential impact are difficult to discern based on
available information. Local sites need guidance to conduct program
evaluations and find creative solutions to enhance employee participation. A
robust measurement system to demonstrate effectiveness is paramount to
ensure the success of this initiative.
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Affiliation(s)
- Freny Shah
- U.S. Department of Veterans Affairs, Atlanta VA Health Care System, Decatur, GA, USA
- Emory University School of Medicine, Atlanta, GA, USA
| | - Joanna R. Sells
- U.S. Department of Veterans Affairs, San Francisco VA Health Care System, San Francisco, CA, USA
- University of California, San Francisco, CA, USA
| | - Jennifer Werthman
- U.S. Department of Veterans Affairs, Tennessee Valley Healthcare System, Nashville, TN, USA
| | - Corrine Abraham
- U.S. Department of Veterans Affairs, Atlanta VA Health Care System, Decatur, GA, USA
- Emory University Nell Hodgson Woodruff School of Nursing, Atlanta, GA, USA
| | - Asma M. Ali
- US Department of Veterans Affairs, Michael E. Debakey VA Medical Center, Houston, TX, USA
- Baylor College of Medicine, Houston, TX, USA
| | - Carol Callaway-Lane
- U.S. Department of Veterans Affairs, Tennessee Valley Healthcare System, Nashville, TN, USA
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Sommer JL, Reynolds K, El-Gabalawy R, Pietrzak RH, Mackenzie CS, Ceccarelli L, Mota N, Sareen J. Associations between physical health conditions and posttraumatic stress disorder according to age. Aging Ment Health 2021; 25:234-242. [PMID: 31769298 DOI: 10.1080/13607863.2019.1693969] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Posttraumatic stress disorder (PTSD) is associated with various physical health conditions. However, it is unclear whether the relationship between PTSD and physical health conditions differs according to age. This study aims to examine the associations between PTSD and physical health conditions across four adult age categories. METHODS We analyzed data from the 2012 to 2013 National Epidemiologic Survey on Alcohol and Related Conditions (N = 36,309). The Alcohol Use Disorder and Associated Disabilities Interview Schedule-5 assessed past-year DSM-5 PTSD. Multiple regression analyses examined associations between PTSD (reference = no PTSD) with number and type of physical health conditions in each age category (18-34: "younger adults," 35-49: "middle-aged adults," 50-64: "young-old adults," 65+: "older adults"). RESULTS The prevalence of nearly all physical health conditions increased according to age, whereas the prevalence of PTSD tended to decrease with age. After adjustment, PTSD was associated with a greater number of physical health conditions among all age categories (b range: 0.62-1.29). Regardless of age category, PTSD was associated with increased odds of cardiovascular and musculoskeletal conditions (AOR range: 1.54-2.34). PTSD was also associated with increased odds of gastrointestinal, hepatobiliary, endocrine/metabolic, respiratory, neurologic conditions, cancer, sleep disorders, and anemia among select age categories (AOR range: 1.70-3.31). For most physical health conditions, the largest effect sizes emerged for younger and middle-aged adults. CONCLUSIONS PTSD is associated with many physical health conditions across the age spectrum, particularly among younger and middle-aged adults. Results may inform targeted screening and intervention strategies to mitigate risk of physical health conditions among adults with PTSD.
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Affiliation(s)
- Jordana L Sommer
- Department of Psychology, University of Manitoba, Winnipeg, Canada.,Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, Canada
| | - Kristin Reynolds
- Department of Psychology, University of Manitoba, Winnipeg, Canada
| | - Renée El-Gabalawy
- Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, Canada.,Department of Clinical Health Psychology, University of Manitoba, Winnipeg, Canada
| | - Robert H Pietrzak
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.,U.S. Department of Veteran Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA
| | | | - Laura Ceccarelli
- Department of Psychology, University of Manitoba, Winnipeg, Canada
| | - Natalie Mota
- Department of Clinical Health Psychology, University of Manitoba, Winnipeg, Canada
| | - Jitender Sareen
- Department of Psychiatry, University of Manitoba, Winnipeg, Canada
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Employee Perceptions of Safety, Health, and Well-Being: Focus Group Findings From One Veterans Affairs Medical Center. J Occup Environ Med 2019; 60:e582-e588. [PMID: 30199468 DOI: 10.1097/jom.0000000000001445] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Focus groups were conducted at one veterans affairs (VA) medical center to understand (1) how the work environment and conditions of work influence employee safety, health, and well-being; (2) what programs, policies, and practices promote and protect employee safety and health in VA; and (3) how employee safety, health, and well-being impact the organizational mission. METHODS Nine focus groups were conducted with leadership, supervisor, and frontline employees. Focus groups were audio recorded, transcribed, and content analysis was performed. RESULTS Fifty-five employees participated in the focus groups. Six common themes emerged-stressful working conditions, health hazards, organizational factors, current program knowledge, participation barriers, and program suggestions. CONCLUSIONS Employees identified organizational and structural elements of work that impact safety, health, and well-being. Application of the Total Worker Health™ hierarchy of controls provided a novel framework for discussion of focus group findings.
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Schult TM, Schmunk SK, Marzolf JR, Mohr DC. The Health Status of Veteran Employees Compared to Civilian Employees in Veterans Health Administration. Mil Med 2019; 184:e218-e224. [DOI: 10.1093/milmed/usy410] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 10/10/2018] [Indexed: 11/13/2022] Open
Abstract
AbstractIntroductionVeterans Health Administration (VHA) is undergoing changes in the practice of health care focusing on approaches that prioritize veteran well-being. Given transformation efforts, opportunities exist to enhance the health and well-being of patients and employees alike – a significant proportion of whom are veterans. To date, differences in health status between veteran and civilian employees within VHA have not been examined.Materials and MethodsData from an annual organizational census survey with health promotion module conducted in 2015 were analyzed to estimate the prevalence of health risk behaviors, mental health, and chronic health conditions by veteran status within genders (n = 86,257). To further examine associations by gender between veteran status and health measures controlling for covariates, multivariate logistic regression analyses were utilized.ResultsPrevalence estimates generally indicated veterans have worse health status and health risk behaviors than their civilian counterparts. Results from multivariate logistic regression analyses indicated many significant associations between veteran status and health by gender controlling for other important demographic variables and a total comorbidity score. Compared to civilian employees within respective genders, both male and female veteran employees have increased odds of being a current smoker. Both male and female veteran employees have decreased odds of physical inactivity compared to civilian employees. For mental health and chronic health conditions, there are several conditions that veteran employees have increased odds for when compared to civilian employees of like gender; these include low back problems, arthritis, anxiety, depression, and sleep disorders.ConclusionsVeteran employees in VHA have worse health status than their civilian counterparts on a number of measures of health risk behaviors, mental health, and chronic health conditions. Given current organizational priorities aimed at cultural transformation, the present time is an optimal one to work collaboratively to enhance the health and well-being services that are available for patients and employees alike. All employees, particularly our unique population of veteran employees, will benefit from such an approach.
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Affiliation(s)
- Tamara M Schult
- Veterans Health Administration, Occupational Safety, Health, and GEMS Programs, One Veterans Drive, Building 10, Minneapolis, MN
| | - Sandra K Schmunk
- Veterans Health Administration, Occupational Safety, Health, and GEMS Programs, One Veterans Drive, Building 10, Minneapolis, MN
| | - James R Marzolf
- Veterans Health Administration, Office of Patient Centered Care and Cultural Transformation, 810 Vermont Avenue NW, Washington D.C
| | - David C Mohr
- Boston VA Health Care System, Center for Healthcare Organization and Implementation Research, 150 South Huntington Avenue, Jamaica Plain, MA
- Boston University School of Public Health, 715 Albany Street, Boston, MA
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The worksite heart health improvement project's impact on behavioral risk factors for cardiovascular disease in long-term care: A randomized control trial. Int J Nurs Stud 2018; 86:107-114. [PMID: 30005312 DOI: 10.1016/j.ijnurstu.2018.06.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 06/22/2018] [Accepted: 06/26/2018] [Indexed: 01/01/2023]
Abstract
BACKGROUND Long-term care workers are at high risk for cardiovascular disease, in part because of their poor health habits. OBJECTIVE The purpose of this study is to test the impact of the Worksite Heart Health Improvement Project (WHHIP) on subjective behavioral cardiovascular risk factors over time among long-term care staff. DESIGN The WHHIP was a 12-month cluster randomized control trial conducted in four long-term care facilities. The exercise, nutrition, and stress management intervention lasted 9-months and was implemented during paid work time. SETTING AND PARTICIPANTS Ninety-eight long-term care workers consented to participate in the study. METHODS Survey data included: mood, dietary salt intake, dietary fat intake, sleep quality, and sleep duration. RESULTS A significant positive short-term intervention effect at 9-month (p = .037) and long-term effect at 12-month for mood (p = .039) was found, signifying reduction in mood symptoms in the treatment group over time. The intervention group also showed longer sleep time (p = .016) and better sleep quality (p = .046) at 12-months. The intervention group had less dietary sodium intake at 9-months (p = .036); yet, this was not maintained over time. CONCLUSION The WHHIP demonstrated the ability to improve participants' mood, sleep and sodium intake over time. Lessons learned particularly the challenges faced implementing the WHHIP and the solutions recommended provide critical insights to strengthen future programs with this population.
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Decreasing Physical Inactivity in the Veterans Health Administration Employee Population. J Occup Environ Med 2018; 58:1217-1222. [PMID: 27930482 DOI: 10.1097/jom.0000000000000892] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to describe a comprehensive approach to decrease physical inactivity in the Veterans Health Administration (VHA) employee population. METHODS The approach included (1) initiatives to decrease physical inactivity in the workplace; (2) two operational surveys to assess system-wide service provision; and (3) two national employee surveys. RESULTS From 2010 to 2012, 86 employee fitness centers were completed in VA medical centers. A grants program (2010 to 2015) funded smaller projects designed to decrease physical inactivity in the workplace. Projects involved the provision of equipment to decrease sedentary behaviors, including stability balls, treadmill and sit-to-stand desks, stairwell projects, and funding for on-site fitness classes, bicycle racks, and outdoor par courses and walking paths among others. CONCLUSIONS A comprehensive approach to decrease physical inactivity in VHA employees was successful. Overall, self-reported, age-adjusted physical inactivity in VHA employees decreased from 25.3% in 2010 to 16.1% in 2015.
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Integrated Employee Occupational Health and Organizational-Level Registered Nurse Outcomes. J Occup Environ Med 2018; 58:466-70. [PMID: 27158954 DOI: 10.1097/jom.0000000000000696] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE The study examined organizational culture, structural supports, and employee health program integration influence on registered nurse (RN) outcomes. METHODS An organizational health survey, employee health clinical operations survey, employee attitudes survey, and administration data were collected. Multivariate regression models examined outcomes of sick leave, leave without pay, voluntary turnover, intention to leave, and organizational culture using 122 medical centers. RESULTS Lower staffing ratios were associated with greater sick leave, higher turnover, and intention to leave. Safety climate was favorably associated with each of the five outcomes. Both onsite employee occupational health services and a robust health promotion program were associated with more positive organizational culture perceptions. CONCLUSIONS Findings highlight the positive influence of integrating employee health and health promotion services on organizational health outcomes. Attention to promoting employee health may benefit organizations in multiple, synergistic ways.
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From Policy to Practice: Tobacco Use Cessation for Employees in the Veterans Health Administration. J Occup Environ Med 2018; 58:525-31. [PMID: 27158961 DOI: 10.1097/jom.0000000000000720] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To describe a comprehensive approach to increase tobacco use cessation in the Veterans Health Administration (VHA) employee population. METHODS The approach included: 1) national policy; 2) a pilot tobacco use cessation program; and 3) two operational surveys to assess system-wide tobacco use cessation service provision. RESULTS The proportion of VHA facilities offering a comprehensive tobacco use cessation program increased from 51% in 2010 to 72% in 2014, with 83% of facilities providing nicotine replacement therapy to employees. The WIN by Quitting Tobacco program was successful; employees who participated in the pilot program quit tobacco at high rates (64% at 1 month post quit date). CONCLUSIONS From policy to practice, the comprehensive approach to tobacco use cessation in VHA was successful and may serve as a model for future workplace health promotion and occupational safety and health initiatives.
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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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Doran K, Resnick B, Kim N, Lynn D, McCormick T. Applying the Social Ecological Model and Theory of Self-Efficacy in the Worksite Heart Health Improvement Project-PLUS. Res Theory Nurs Pract 2017; 31:8-27. [DOI: 10.1891/1541-6577.31.1.8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background: Long-term care (LTC) employees are at high risk for cardiovascular disease. Despite the documented benefits of worksite health promotion (WHP) programs for employees and employers and the potential benefits to residents in LTC facilities, LTC employees are rarely offered WHP programs. Purpose: The purpose of the intervention described in this article is to reduce cardiovascular disease risk factors among LTC workers using a physical activity, nutrition, and stress management WHP implemented during paid work time with 98 LTC staff members. Methods: This article describes a 9-month physical activity, nutrition, and stress management WHP intervention delivered during paid work time to reduce the cardiovascular disease risk of employees working in LTC. The intervention is rooted in the social ecological model and social cognitive theory. The intervention is based on formative research and evidence-based practice recommendations and is specifically designed to reduce barriers to intervention participation (e.g., inconsistent break times and unpredictable resident care needs) and enhance motivators to program participation (e.g., enhanced social support). Results: The intervention is ongoing, but measures are described. Conclusion: As more employers offer WHP programs, it is important that programs are tailored to meet specific employee groups and work environments. This article operationalizes a WHP research protocol with LTC employees that can be applied to reduce cardiovascular disease risk in LTC employees or similar employee groups in similar work environments.
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Tucker S, Farrington M, Lanningham-Foster LM, Clark MK, Dawson C, Quinn GJ, Laffoon T, Perkhounkova Y. Worksite Physical Activity Intervention for Ambulatory Clinic Nursing Staff. Workplace Health Saf 2016; 64:313-25. [PMID: 27143144 DOI: 10.1177/2165079916633225] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Health behaviors, including physical activity (PA), of registered nurses (RNs) and medical assistants (MAs) are suboptimal but may improve with worksite programs. Using a repeated-measures crossover design, the authors explored if integrating a 6-month worksite non-exercise activity thermogenesis (NEAT) intervention, with and without personalized health coaching via text messaging into workflow could positively affect sedentary time, PA, and body composition of nursing staff without jeopardizing work productivity. Two ambulatory clinics were randomly assigned to an environmental NEAT intervention plus a mobile text message coaching for either the first 3 months (early texting group, n = 27) or the last 3 months (delayed texting group, n = 13), with baseline 3-month and 6-month measurements. Sedentary and PA levels, fat mass, and weight improved for both groups, significantly only for the early text group. Productivity did not decline for either group. This worksite intervention is feasible and may benefit nursing staff.
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Federal workers' compensation programs: Department of Defense and Veterans Health Administration experiences. J Occup Environ Med 2015; 57 Suppl 3:S1-3. [PMID: 25741608 DOI: 10.1097/jom.0000000000000367] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The objective of this article is to introduce the reader to this special supplement to the Journal of Occupational and Environmental Medicine regarding Federal Workers' Compensation Programs. METHODS The short history of both the VHA and DoD Federal Workers' Compensation Programs are provided and a short synopsis of each author's article is provided. RESULTS The lessons learned from the articles in the supplement are summarized in this article and 6 key findings are highlighted. CONCLUSIONS Cooperation between human resources workers' compensation personnel, safety and occupational health personnel is a must for successful management of the WC program. Information and data sharing are critical for root cause and injury prevention, case management, and cost containment efforts. Enhancing efforts in these areas will save an estimated $100 million through cost avoidance efforts.
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Foster-Chang SA, Manning ML, Chandler L. Tuberculosis Screening of New Hospital Employees. Workplace Health Saf 2014; 62:460-7. [DOI: 10.3928/21650799-20140902-02] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Accepted: 07/25/2014] [Indexed: 01/18/2023]
Abstract
Selection of the most suitable test(s) for detection of Mycobacterium tuberculosis (TB) infection should be based on purpose, setting, effectiveness, and cost. Two tests are available to screen for latent TB: the tuberculin skin test (TST) and the more recent interferon-gamma release assays (IGRAs). Based on the administrative, logistic, and technical ease of use, an IGRA trial was initiated by the occupational health department at an urban Veteran's Administration health care facility for TB screening of new employees. As a result, new employees completing the pre-placement process within the organization's designated 14 days increased from 77% to 97%, new employee clearance to work time decreased from 13.18 to 5.91 days, and new employee TB screening costs were reduced by 40%. The IGRA is an acceptable alternative to the TST and has significant potential to improve the process of pre-placement TB screening.
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Hull A, Reinhard M, McCarron K, Allen N, Jecmen MC, Akhter J, Duncan A, Soltes K. Acupuncture and meditation for military veterans: first steps of quality management and future program development. Glob Adv Health Med 2014; 3:27-31. [PMID: 25105073 PMCID: PMC4104562 DOI: 10.7453/gahmj.2013.050] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Veterans of all war eras have a high rate of chronic disease, mental health disorders, and chronic multi-symptom illnesses (CMI).(1-3) Many veterans report symptoms that affect multiple biological systems as opposed to isolated disease states. Standard medical treatments often target isolated disease states such as headaches, insomnia, or back pain and at times may miss the more complex, multisystem dysfunction that has been documented in the veteran population. Research has shown that veterans have complex symptomatology involving physical, cognitive, psychological, and behavioral disturbances, such as difficult to diagnose pain patterns, irritable bowel syndrome, chronic fatigue, anxiety, depression, sleep disturbance, or neurocognitive dysfunction.(2-4) Meditation and acupuncture are each broad-spectrum treatments designed to target multiple biological systems simultaneously, and thus, may be well suited for these complex chronic illnesses. The emerging literature indicates that complementary and integrative medicine (CIM) approaches augment standard medical treatments to enhance positive outcomes for those with chronic disease, mental health disorders, and CMI.(5-12.)
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Affiliation(s)
- Amanda Hull
- War Related Illness and Injury Study Center, Veteran Affairs Medical Center, Washington, DC, United States
| | - Matthew Reinhard
- War Related Illness and Injury Study Center, Veteran Affairs Medical Center, Washington, DC, United States
| | - Kelly McCarron
- War Related Illness and Injury Study Center, Veteran Affairs Medical Center, Washington, DC, United States
| | - Nathaniel Allen
- War Related Illness and Injury Study Center, Veteran Affairs Medical Center, Washington, DC, United States
| | - M Cory Jecmen
- War Related Illness and Injury Study Center, Veteran Affairs Medical Center, Washington, DC, United States
| | - Jeanette Akhter
- War Related Illness and Injury Study Center, Veteran Affairs Medical Center, Washington, DC, United States
| | - Alaine Duncan
- War Related Illness and Injury Study Center, Veteran Affairs Medical Center, Washington, DC, United States
| | - Karen Soltes
- War Related Illness and Injury Study Center, Veteran Affairs Medical Center, Washington, DC, United States
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Flannery K, Resnick B, Akpadiaha I, McMullen TL. The cardiovascular health status of minority female nursing assistants working in long-term care: A pilot study. Heart Lung 2014; 43:177-82. [DOI: 10.1016/j.hrtlng.2014.02.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Revised: 02/14/2014] [Accepted: 02/14/2014] [Indexed: 11/15/2022]
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Flannery K, Burket TL, Resnick B. Exercise habits of licensed nurses and nursing assistants: Are they meeting national guidelines? Geriatr Nurs 2014; 35:S17-20. [DOI: 10.1016/j.gerinurse.2014.02.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Management support, worksite culture, and local resources for healthier employees: the Veterans Affairs experience. J Occup Environ Med 2013; 55:310-7. [PMID: 23302701 DOI: 10.1097/jom.0b013e31827dba1e] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To determine whether a "worksite culture of health" exists within the Veterans Health Administration and implications on integrating employee health promotion programs. METHODS Three national surveys were used-an organizational health survey, a health behaviors survey, and a worksite environment survey. Cross-sectional associations between measures of organizational health and employee health behaviors and between measures of organizational health and worksite environment were assessed. RESULTS There were significant associations between a number of organizational health measures and a combined measure of health behaviors. Likewise, presence of employee-wellness committees and/or coaches was significantly associated with higher appraisal on organizational health measures. CONCLUSION Results suggest that a worksite culture of health exists in some but not all facilities within Veterans Health Administration; this has implications for integrating employee health promotion programs systemwide. A phased-in approach is likely warranted.
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Schult TM, Awosika ER, Hodgson MJ, Hirsch PR, Nichol KL, Dyrenforth SR, Moore SC. Innovative approaches for understanding seasonal influenza vaccine declination in healthcare personnel support development of new campaign strategies. Infect Control Hosp Epidemiol 2012; 33:924-31. [PMID: 22869267 DOI: 10.1086/667370] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE The main objectives of our study were to explore reasons for seasonal influenza vaccine acceptance and declination in employees of a large integrated healthcare system and to identify underlying constructs that influence acceptance versus declination. Secondary objectives were to determine whether vaccine acceptance varied by hospital location and to identify facility-level measures that explained variability. DESIGN A national health promotion survey of employees was conducted that included items on vaccination in the 2009-2010 influenza season. The survey was administered with two other institutional surveys in a stratified fashion: approximately 40% of participating employees were randomly assigned to complete the health promotion survey. SETTING National single-payer healthcare system with 152 hospitals. PARTICIPANTS Employees of the healthcare system in 2010 who responded to the survey. METHODS Factor analysis was used to identify underlying constructs that influenced vaccine acceptance versus declination. Mean factor scores were examined in relation to demographic characteristics and occupation. Multilevel logistic regression models were used to determine whether vaccine acceptance varied by location and to identify facility-level measures that explained variability. RESULTS Four factors were identified related to vaccine declination and were labeled as (1) "don't care," (2) "don't want," (3) "don't believe," and (4) "don't know." Significant differences in mean factor scores existed by demographic characteristics and occupation. Vaccine acceptance varied by location, and vaccination rates in the previous year were an important facility-level predictor. CONCLUSIONS Results should guide interventions that tailor messages on the basis of particular reasons for declination. Occupation-specific and culturally appropriate messaging should be considered. Continued efforts will be taken to better understand how workplace context influences vaccine acceptance.
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Affiliation(s)
- Tamara M Schult
- Office of Public Health, Veterans Health Administration, Washington, DC, USA.
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