Protocol: a multi-level intervention program to reduce stress in 9-1-1 telecommunicators

Effect of Mandatory and Voluntary Overtime Hours on Stress Among 9-1-1 Telecommunicators

BACKGROUND

9-1-1 telecommunicators are frequently exposed to indirect traumatic events that impact their mental and physical health and are often required to work overtime with rotating shifts. Previous studies reported various harmful effects of overtime on the health and well-being of workers, such as musculoskeletal injuries, burnout, low job satisfaction, fatigue, and intent to leave. However, there is limited research on the impact of overtime hours on 9-1-1 telecommunicators' stress symptoms, especially mandatory overtime hours. This study aimed to examine the relationship between overtime hours-mandatory and voluntary-and the level of stress symptoms among 9-1-1 telecommunicators.

METHODS

We used secondary data from the surveys of the "Multi-tasking to hyper-tasking: Investigating the impact of Next Generation 9-1-1" study for analysis. Linear mixed-effects regression was applied to examine the association of overtime hours with the stress level.

RESULTS

Of the 403 participants, 47.6% reported that they were required to work mandatory overtime, and the mean mandatory overtime was 7.51 (SD = 12.78) hours in the past month. 58.3% reported working voluntary overtime, and the mean voluntary overtime was 11.63 (SD = 17.48) hours. This study found that mandatory overtime hours were associated with an increase in self-reported stress symptoms (β = 0.30, p = .002), whereas no significant association was found between voluntary overtime and the level of stress symptoms (β = -0.01, p = .885).

CONCLUSION/APPLICATION TO PRACTICE

Study results highlight the importance of reducing mandatory overtime in call centers as one possible strategy for reducing stress levels among this critical workforce.

Having Children and Being Married Are Predictors of Burnout and Obesity Among Working Men: Effects of Latent Profile Analysis

Emergency call-takers and dispatchers' (ECDs) work makes them vulnerable to occupational burnout and health problems. The aim of this research was to apply a Person-Oriented approach in order to examine the relationships between burnout risk factors (having children), personal resources (being married), and health consequences (overweight and obesity) among men working in these positions. The burnout syndrome was assessed among 228 Polish ECDs using The Link Burnout Questionnaire and the method of latent profile analysis (LPA). All ECDs were characterized by high levels of occupational burnout exhibited in 3 out of its 4 dimensions. The LPA allowed us to differentiate 4 patterns of burnout, taking into account socio-demographic variables, the length of employment as ECD and body weight. The need to balance the demands of professional work with having children and marital roles played an important role in predicting the level of professional burnout. There was a relationship between the dimensions of occupational burnout and age, being married, and having children. Being married was associated with a greater intensity of emotional exhaustion, and the level of exhaustion was higher if the employee had children in their care. Health consequences in the form of overweight and obesity can be associated with levels of emotional exhaustion and professional effectiveness. The application of the Person-Oriented approach presents hidden correlations between burnout predictors and health consequences.

"If you miss that first step in the chain of survival, there is no second step"-Emergency ambulance call-takers' experiences in managing out-of-hospital cardiac arrest calls

When a person has an out-of-hospital cardiac arrest (OHCA), calling the ambulance for help is the first link in the chain of survival. Ambulance call-takers guide the caller to perform life-saving interventions on the patient before the paramedics arrive at the scene, therefore, their actions, decisions and communication are integral to saving the patient's life. In 2021, we conducted open-ended interviews with 10 ambulance call-takers with the aim of understanding their experiences of managing these phone calls; and to explore their views on using a standardised call protocol and triage system for OHCA calls. We took a realist/essentialist methodological approach and applied an inductive, semantic and reflexive thematic analysis to the interview data to yield four main themes expressed by the call-takers: 1) time-critical nature of OHCA calls; 2) the call-taking process; 3) caller management; 4) protecting the self. The study found that call-takers demonstrated deep reflection on their roles in, not only helping the patient, but also the callers and bystanders to manage a potentially distressing event. Call-takers expressed their confidence in using a structured call-taking process and noted the importance of skills and traits such as active listening, probing, empathy and intuition, based on experience, in order to supplement the use of a standardised system in managing the emergency. This study highlights the often under-acknowledged yet critical role of the ambulance call-taker in being the first member of an emergency medical service that is contacted in the event of an OHCA.

Latent Occupational Burnout Profiles of Working Women

According to scientific research, emergency call-takers and dispatchers (ECD) are particularly vulnerable to burnout syndrome. It can be observed that this occupation is predominantly performed by women. Moreover, the studies on occupational burnout indicate its different causes depending on employees’ gender. The aim of this research was to apply a Person-Oriented approach in order to examine the relationships between particular risk factors, the level of burnout, and its health consequences in a group of women. A cross-sectional survey study was conducted on 296 women (call-takers and dispatchers) from public-safety answering points in Poland. The Link Burnout Questionnaire and a sociodemographic questionnaire were used to gather information. The method of latent profile analysis (LPA) was employed in the study. The study revealed burnout patterns without full symptoms as well as four different burnout profiles. The findings partially confirmed initial assumptions about correlations between the length of service as ECD, marital status, motherhood, burnout symptoms, and body mass index (BMI). Sociodemographic variables differentiated the examined women in terms of their emotional exhaustion and BMI. Three groups of women at risk of burnout and overweight were identified: those with the shortest job experience, those with the longest job experience, and an intermediate group. In each of these groups, symptoms indicating a possible risk of burnout-related health issues could be observed. The application of a Person-Oriented approach allowed for assessing possible correlations between burnout risk factors, its symptoms, and health consequences.

The Impact of the COVID-19 Pandemic on Intimate Partner Violence Advocates and Agencies

Relatively few studies have considered the impact of the COVID-19 pandemic on intimate partner violence (IPV) advocates or the agencies where they work. In this study, based on United States IPV advocates' experiences working with survivors during the COVID-19 pandemic, we conducted interviews to explore: 1) personal challenges and resilience working as IPV advocates during the COVID-19 pandemic; 2) how agencies adapted to the pandemic to support IPV survivors and advocates; and 3) specific needs and challenges of culturally-specific agencies. We conducted semi-structured interviews with 53 IPV advocates from June to November 2020. Participants were included if they worked directly with survivors, identified as an IPV advocate, worked at a US-based agency, and spoke and understood English. We created a sampling matrix to ensure adequate representation from IPV advocates serving survivors from communities which have been marginalized. Interviews were conducted through a virtual platform by a trained member of the research team. We used an inductive thematic analysis approach, with weekly coding meetings to resolve discrepancies in coding. Five themes emerged from the data: 1) IPV advocates described how working as an IPV advocate during the COVID-19 pandemic impacted them personally; 2) agencies developed new methods of addressing IPV advocates' needs; 3) agencies developed new solutions to address pandemic-related client needs; 4) transitioning advocacy work to virtual formats created challenges but also opportunities and; 5) pandemic limitations and impacts compounded pre-pandemic challenges for culturally specific agencies. IPV advocates are frontline workers who have played essential roles in adjusting services to meet survivor needs during the COVID-19 pandemic while simultaneously coping with pandemic impacts on themselves and their agencies. Developing inter-agency collaborations and promoting advocates' safety and wellbeing during future public health crises will help support IPV survivors.

Participant Engagement in and Perspectives on a Web-Based Mindfulness Intervention for 9-1-1 Telecommunicators: Multimethod Study

Background

Demanding working conditions and secondary exposure to trauma may contribute to a high burden of stress among 9-1-1 telecommunicators, decreasing their ability to work effectively and efficiently. Web-based mindfulness-based interventions (MBIs) can be effective in reducing stress in similar populations. However, low engagement may limit the effectiveness of the intervention.

Objective

The aim of this study was to assess participant engagement in a Web-based MBI designed for 9-1-1 telecommunicators. Specifically, we sought to describe the following: (1) participant characteristics associated with intervention engagement, (2) participant perspectives on engaging with the intervention, and (3) perceived challenges and facilitators to engaging.

Methods

We used qualitative and quantitative data from participant surveys (n=149) that were collected to assess the efficacy of the intervention. We conducted descriptive and bivariate analyses to identify associations between demographic, psychosocial, and workplace characteristics and engagement. We conducted a thematic analysis of qualitative survey responses to describe participant experiences with the MBI.

Results

We found that no individual participant characteristics were associated with the level of engagement (low vs high number of lessons completed). Participant engagement did vary by the call center (P<.001). We identified the following overarching qualitative themes: (1) the participants perceived benefits of mindfulness practice, (2) the participants perceived challenges to engage with mindfulness and the intervention, and (3) intervention components that facilitated engagement. The participants expressed positive beliefs in the perceived benefits of practicing mindfulness, including increased self-efficacy in coping with stressors and increased empathy with callers. The most commonly cited barriers were work-related, particularly not having time to participate in the intervention at work. Facilitators included shorter meditation practices and the availability of multiple formats and types of intervention content.

Conclusions

The findings of this study suggest that efforts to improve intervention engagement should focus on organizational-level factors rather than individual participant characteristics. Future research should explore the effect of mindfulness practice on the efficiency and effectiveness of 9-1-1 telecommunicators at work.

Trial Registration

ClinicalTrials.gov NCT02961621; https://clinicaltrials.gov/ct2/show/NCT02961621

Destress 9-1-1-an online mindfulness-based intervention in reducing stress among emergency medical dispatchers: a randomised controlled trial

OBJECTIVES

Emergency medical dispatchers (EMDs) experience significant stress in the workplace. Yet, interventions aimed at reducing work-related stress are difficult to implement due to the logistic challenges associated with the relatively unique EMD work environment. This investigation tested the efficacy of a 7-week online mindfulness-based intervention (MBI) tailored to the EMD workforce.

METHODS

Active-duty EMDs from the USA and Canada (n=323) were randomly assigned to an intervention or wait list control condition. Participants completed surveys of stress and mindfulness at baseline, post intervention, and 3 months follow-up. Repeated measures mixed effects models were used to assess changes in stress and mindfulness.

RESULTS

Differences between the intervention group and control group in pre-post changes in stress using the Calgary Symptoms of Stress Inventory were statistically significant, with a difference of -10.0 (95% CI: -14.9, -5.2, p<0.001) for change from baseline to post intervention, and a difference of -6.5 (95% CI: -11.9, -1.1, p=0.02) for change from baseline to 3 months follow-up. Change in mindfulness scores did not differ between groups. However, increases in mindfulness scores were correlated with greater reductions in stress for all participants, regardless of group (r=-0.53, p<0.001).

CONCLUSIONS

Development of tailored online MBIs for employees working in challenging work environments offer a promising direction for prevention and intervention. This study found that a short, weekly online MBI for EMDs resulted in reductions in reports of stress. Implications of online MBIs in other emergency responding populations and directions for future research are discussed.