Obstacles and Future Prospects: Considerations on Health Promotion Activities for Older Workers in Europe

Exploring workability in an older working population: associations with cognitive functioning, sleep quality, and technostress

Objective

This observational study investigates workability and its associations with cognitive functioning, sleep quality and technostress among an older working population, also shedding light on potential differences between two occupational categories with different work schedules.

Methods

Workers aged over 50, employed in different working sectors (banking/finance, chemical and metal-mechanic industry) were administered a self- report questionnaire including Work Ability Index (WAI), cognitive tests (Stroop Color Task, Corsi Blocks, Digit Span), sleep quality questionnaires (Pittsburgh Sleep Quality Index-PSQI; Insomnia Severity Index-ISI; Ford Insomnia Response to Stress Test-FIRST) and technostress scale. Linear regression models evaluated associations among variables, interaction effects investigated potential moderators.

Results

A total of 468 aged workers categorized as white (WCWs; N = 289, 62%) or blue collars (BCWs; N = 179, 38%) were enrolled; most BCWs (N = 104; 58%) were night shift workers. WCWs reported higher workability, cognitive functioning, sleep quality and lower technostress (except for invasion and privacy subscales) than BCWs. Associations between cognitive functioning and workability were statistically significant only for BCWs [slopes equal to 0.2 (0.33), 0.8 (0.34), -0.02 (0.001) for Memory Span Corsi, Block Span Digit and Interference Speed respectively]; additionally, sleep quality significantly moderated this association (p = 0.007). Higher levels of technostress were associated with lower workability, and this relationship was stronger for BCWs.

Conclusion

The aging of the workforce has important implications for occupational health and safety. Our findings suggest potential interventions and protective measures to promote older workers' wellbeing; blue-collar workers particularly should benefit from tailored intervention to sustain workability and prevent technostress, considering the role of healthy sleep habits promotion.

How the interplay of late retirement, health care, economic insecurity, and electronic social contact affects the mental health amongst older workers?

The delayed retirement initiative has become increasingly emphasised to cope with the population ageing. Based on the social-ecological model, this study explores the interplay of late retirement, health care, economic insecurity, and electronic social contact on mental health of older workers. Using data from the Survey of Health, Ageing and Retirement in Europe (wave 8), results show that the late retirement, health care quality, and electronic social contact are all negatively associated with the mental health problems among older workers. Besides, the influence of health care quality and electronic social contact on mental health problems are buffered by the economic insecurity respectively. It is concluded that more targeted policy response is in need to achieve better health outcomes among older workers.

Establishing an index for monitoring occupational health and well-being of coal mines: Consideration of individual characteristics

It is crucial to enhance employee occupational health and well-being (OHW) for the well-run and prosperity of the industry, but there is very limited knowledge on the assessment of miners' well-being that differs from person to person. Within this study, a new more direct method, as well as an instrument was constructed to measure the OHW through data analysis based on a representative sample of coal miners (N = 1037). Initially, the causal pathway of job stress and health consequences was characterized by the driving force-pressure-state-impact-response (DPSIR) model. The OHW index was represented by hazards, vulnerability, and severity through the data envelopment analysis and stochastic frontier approach method. The result was that the severity of the consequences of inadequate organizational response was the dominant factor. 75% of employees with poor OHW work in mining, and digging areas, including various drivers and support workers. This study provides an innovative and complete description of the interaction mechanisms among job stress, job burnout, and health outcomes. It demonstrates that a three-level assessment method, namely hazards-vulnerability-severity, can effectively identify hierarchical management points. We provide metrics, objective data, and evidence-based recommendations on stress and health management for miners.

Healthcare workers' self-regulatory eating behaviours are associated with being stress-free during the Covid-19 lockdown in Singapore

Our study sought to examine the impact of the pandemic and the Circuit-breaker (CB) measures on dietary behaviours of healthcare workers (HCW). In addition, the association between self-regulatory eating behaviours and psychological stress was explored. Our study employed a cross-sectional anonymous survey that examined the demographics, dietary habits, self-regulatory eating behaviours (SR) and their association to stress levels of healthcare workers (HCWs) before and during the Circuit Breaker (CB) in Singapore. The survey was conducted over four weeks from May 17 to June 18, 2020. Snowball sampling was performed in the final week. A total of 707 participants took part in the survey. Due to the CB measures and modifications of work scope and work areas, there were significant changes in their dietary behaviors before CB versus during the CB period (n = 707), with many reducing the intake of vegetables (p = 0.018) while increasing their intake of unhealthy food choices such as canned drinks (p = 0.002), convenience food (p ≤ 0.001) and alcoholic drinks (p = 0.034). Before the CB period, 91.8% (602/656) of participants who intended to have a healthy diet were classified in medium-to-high SR groups whereas during the CB period, 87.7% (575/656) were in medium-to-high SR groups and the difference was statistically significant (p = 0.011). Nurses, administrative staff, HCWs of Chinese and Indian ethnicities, staff who did not complete university education and those who did not have domestic helpers were more likely to have reduced SR. Importantly, amongst participants who intended to have a healthy diet, 70.9% displayed no change or improved eating habits and showed medium-to-high levels of SR during CB. Participants with no changes in SR were 2.11 times more likely to be stress-free as compared to those who had deteriorated SR (OR 2.11 95% CI 1.27–3.48, p = 0.004). Due to CB measures and work modifications, dietary behaviours of HCWs deteriorated with increased intake of unhealthy food choices. HCWs who maintain their self-regulatory eating behaviour are more likely to be stress-free. Short screening questionnaires based on SR changes should be developed and explored as surveillance tools for assessment of HCWs’ general well-being such that personalized interventions to vulnerable groups of workers could be implemented effectively on the ground.

Headache in the Workplace: Analysis of Factors Influencing Headaches in Terms of Productivity and Health

Headache is a very common condition that can have a significant impact on work. This study aimed to assess the prevalence of headaches and their impact on a sample of 1076 workers from 18 small companies operating in different sectors. The workers who volunteered to participate were asked to fill in the Headache Impact Test-6 (HIT-6) and answer questions designed to assess stressful and traumatic factors potentially associated with headaches. The volunteers subsequently underwent a medical examination and tests for diagnosing metabolic syndrome. Out of the 1044 workers who completed the questionnaire (participation rate = 97%), 509 (48.8%) reported suffering from headaches. In a multivariate logistic regression model, female gender, recent bereavement, intrusive leadership, and sleep problems were significantly associated with headaches. In univariate logistic regression models, headache intensity was associated with an increased risk of anxiety (OR 1.10; CI95% 1.09; 1.12) and depression (OR 1.09; CI95% 1.08; 1.11). Headache impact was also associated with the risk of metabolic syndrome (OR 1.02; CI95% 1.00, 1.04), obesity (OR 1.02, CI95% 1.01; 1.03), and reduced HDL cholesterol (OR 1.03; CI95% 1.01; 1.04). The impact of headache calls for intervention in the workplace not only to promote a prompt diagnosis of the different forms of headaches but also to improve work organization, leadership style, and the quality of sleep.

Older Male Construction Workers and Sustainability: Work-Related Risk Factors and Health Problems

This study aims to analyze the characteristics of working conditions, exposure to risk factors, and health-related problems of older male construction workers. In this study, 1519 male construction workers were the subjects of study, and the working conditions, exposure to occupational risk factors, and physical health-related problems were compared among workers under 50 years, in their 50s, and 60 or over. Older male construction workers have lower educational backgrounds and lower average salaries. The degree of exposure to risk factors was higher in workers aged 60 or over than other age groups, such as high temperature, awkward posture, manual material handling, standing posture, repetitive motion, fumes/dust, vapor, skin contact, and tobacco smoke. In addition, the complaint rate of hearing problems, overall fatigue, backache, upper limb pain, or lower limb pain was higher in older workers. In particular, the complaint rate of musculoskeletal pain was 56.6%, overall fatigue was 40.3%, and the rate of depression symptoms was 41.9%. This study shows a high prevalence of musculoskeletal disorders, overall fatigue, and depression symptoms of male elderly construction workers, suggesting that comprehensive support is needed to improve not only the working conditions of workers but also psychological health problems.

Aging and the Future of Decent Work

The United Nations identified decent work and economic growth as a sustainable development goal for 2030. Decent work is a term that sums up aspirations for people in their working lives. One of the factors that influences the achievement of decent work is aging. This article examines how aspects of aging and organizational factors affect work ability across the lifespan and throughout one's work career. Additionally, the critical issue of worker physical mobility was also addressed as a practical limitation to functional aging. Through our investigation, we identified gaps in the literature where research and interventions should be promoted. These include early disability studies; population dashboards of workers' health metrics; intervention and cost effectiveness in health promotion and prevention of early functional aging at work; policies for tailoring demands to individual needs and abilities; and inequities of social protection for aging workers.

Evolution of Human Memory B Cells From Childhood to Old Age

High quality medical assistance and preventive strategies, including pursuing a healthy lifestyle, result in a progressively growing percentage of older people. The population and workforce is aging in all countries of the world. It is widely recognized that older individuals show an increased susceptibility to infections and a reduced response to vaccination suggesting that the aged immune system is less able to react and consequently protect the organism. The SARS-CoV-2 pandemic is dramatically showing us that the organism reacts to novel pathogens in an age-dependent manner. The decline of the immune system observed in aging remains unclear. We aimed to understand the role of B cells. We analyzed peripheral blood from children (4-18 years); young people (23-60 years) and elderly people (65-91 years) by flow cytometry. We also measured antibody secretion by ELISA following a T-independent stimulation. Here we show that the elderly have a significant reduction of CD27dull memory B cells, a population that bridges innate and adaptive immune functions. In older people, memory B cells are mostly high specialized antigen-selected CD27bright. Moreover, after in vitro stimulation with CpG, B cells from older individuals produced significantly fewer IgM and IgA antibodies compared to younger individuals. Aging is a complex process characterized by a functional decline in multiple physiological systems. The immune system of older people is well equipped to react to often encountered antigens but has a low ability to respond to new pathogens.

Using intervention mapping to develop 'Healthy HR' aimed at improving sustainable employability of low-educated employees

BACKGROUND

The perspectives of low-educated employees are often neglected when designing sustainable employability (SE) interventions. As a result, the interventions offered by the employer do often not align with the needs of low-educated employees. This particular group should therefore be actively involved in the process of developing and implementing SE interventions in their work organizations. The current paper describes the development process of a web-based intervention for HR managers and direct supervisors aimed at improving the SE of low-educated employees. This intervention is specifically designed to involve low-educated employees.

METHODS

The first four steps of the Intervention Mapping (IM) approach were used to systematically develop the intervention with the active involvement of stakeholders. Step 1 comprised a needs assessment including a literature review, empirical evidence, scoping search and several focus group interviews with employees and with representatives of employers. Step 2 formulated the intervention objective. During step 3, suitable theoretical methods were selected and translated to practical applications. Step 4 involved the development of a web-based intervention by integrating all information from the preceding steps.

RESULTS

The needs assessment indicated that the employees' active involvement and employees-employer genuine dialogue should be essential characteristics of an SE intervention for low-educated employees. The online toolkit 'Healthy HR' (HHR) was developed, which contains eight steps. Each step consists of one or more tasks helping the employer and employees with developing and implementing SE interventions themselves. One or more dialogue-based tools support each task. The leading principle providing structure within HHR was Adapted Intervention Mapping.

CONCLUSION

Principles of IM appeared to be useful to develop the intervention HHR systematically. This development process resulted in a practical online toolkit that supports employers in the development and implementation of local SE interventions tailored to the needs of low-educated employees. These employees should be actively involved in the process through a dialogue-based approach. By using IM principles, HHR is expected to increase the effectiveness in bettering the health and well-being of low-educated employees.

The management of the new and emerging musculoskeletal and psychosocial risks by EU-28 enterprises

INTRODUCTION

Although the strategic framework of the European Union in the field of Health and Safety at Work 2014-2020 considers as one of its main challenges to improve the prevention of diseases related to NERs (New and Emerging Risks) (European Commission, 2014) there are still not many studies in the literature related to them.

METHOD

An exploratory study was carried out in order to get a picture of the NERs management in the UE-28 countries. The sample was extracted from the ESENER-2 datasets. ESENER-1 was carried out in 2009 and ESENER- 2 in 2014. This survey explores managers' and workers representatives' opinions on health and safety management. It surveyed over 49,000 enterprises in 36 countries.

RESULTS

The results obtained confirm that there are significant differences between the EU-28 countries in terms of the identification and the management of NERs. Conclusions NERs are becoming an increasingly studied phenomenon due to the changes that are taking place in the labour market: the percentage of temporary workers is increasing, the demands to the workers due to the globalization of the market are more complex and all this with an aging working force. Pratical A pplications It would be necessary to rethink the management of OHS, so that managers are aware that the combination of musculoskeletal and psychosocial risks should have a global approach in order to reduce accident and disability rates.

Profiles of total worker health® in United States small businesses

BACKGROUND

The Total Worker Health® (TWH) approach is a best practice method to protect and promote worker safety, health, and well-being. Central to this approach is leadership support and health and safety climates that support day-to-day use of health and safety policies and programs. There is some research that supports these relationships, but there is limited research amongst small businesses. Furthermore, it remains to be shown what role TWH business strategies, as reflected by organizational policies and programs, play in this process. The purpose of this study is to characterize small businesses by their organizations' TWH approach and assess the relationship of these approaches to employee health and safety behaviors.

METHODS

We utilized cross-sectional data from 97 businesses participating in the Small+Safe+Well study. We collected data using a business assessment tool, Healthy Workplace Assessment™, and an employee assessment tool, Employee Health and Safety Culture Survey. We used latent profile analysis at the business level to identify subgroups of businesses based on a set of characteristics from these assessments. Linear regression analysis at the employee level was used to determine profile association with employee safety and health behaviors.

RESULTS

There were two profiles characterized by the lowest (33% of all businesses) and highest (9%) levels of the indicators. There were also two profiles with higher scores on two of the different foci on either TWH business strategies (27%) or leadership and climate (31%). Employees working for a business with a profile that focused on leadership and climate, in addition to having a business strategy, reported the best safety and health behaviors.

CONCLUSIONS

Our study demonstrates that employee engagement in TWH will be highest when businesses have a strategy for how they implement a TWH approach and when they demonstrate leadership commitment to these strategies and foster positive safety and health climates. Our results offer suggestions on how to use TWH assessments to develop interventions for small businesses. More research is needed to understand whether small businesses can improve upon their profile overtime, whether these changes depend on contextual factors, and whether TWH interventions can help them improve their profile.

Description of an integrated e-health monitoring system in a Portuguese higher education institution: the e.cuidHaMUstm program

BACKGROUND

The World Health Organization and the International Labour Organization recognize that workplace health is not only affected by occupational hazards, but is mainly affected by social determinants and individual factors. An accelerated rise in noncommunicable diseases has fostered the importance of creating supportive environments and encouraging healthy behaviours. Therefore, an operational approach to making workplaces healthy and sustainable is needed. This paper describes the development of an e-Health monitoring program entitled 'Integrated eHealth Monitoring System for Health Management in Universities' (e.cuidHaMUs^TM) as a possible solution to that operational approach.

METHODS

We developed the program e.cuidHaMUs^TM that proposes to detect risk behaviours related to noncommunicable diseases and to implement problem-solving measures by establishing a health-promoting workspace in a Portuguese higher education institution. Based on the 'I-Change' conceptual model, our program provides personalized feedback; improves health-related knowledge, attitude and good practices; and encourages actions to promote healthy lifestyles through individual health capacitation. Focusing on evaluation as an activity that generates knowledge, the e.cuidHaMUs^TM program aggregates all the relevant health information, shares the results with decision-makers and evaluates health-related policy changes in the workplace.

DISCUSSION

This paper presents the design of the e.cuidHaMUs^TM program, the development of an eHealth web platform to share information between the different stakeholders, and a questionnaire to evaluate the health status of higher education institution workers (e.cuidHaMUs.QueST®). Also, the procedures for data collection and analysis are outlined. The e.cuidHaMUs^TM program can enhance health surveillance through cross-sectional and longitudinal studies and provide scientific evidence to support the envisioned interventions and promotions of healthy lifestyles. This program is an effort to incorporate a holistic culture of health-promoting workspace in higher education institution policies.

New and Emerging Risk Factors in Occupational Health

Workplace health and safety is constantly evolving both in developed and developing countries. Under the tumultuous development of technology, working environments are changing, leading to the onset of new occupational hazards and unprecedented risk conditions deriving from the new ways of organizing work. At the same time, progress in medical science, with the knowledge in the fields of genetics, metabolomics, big data, and smart technologies, makes it possible to promptly identify and treat risk conditions that would have escaped notice in the past. Personalized occupational medicine represents the frontier of prevention in the workplace, from the perspective of total worker health and the sustainability of resources. The contributions to this Special Issue range from chemical, physical, and biological to psychosocial risks, and from the search for new ways to control long-known risks, such as mercury toxicity, to observations of the most frequent pathologies in the workplace in the last twenty years, such as repetitive trauma diseases, immunodeficiency transmitted as a result of biological injuries, and violence and psychological trauma in the workplace. New insights are needed in occupational health and safety practice to address the new challenges in this field.

Return on Investment (ROI) and Development of a Workplace Disability Management Program in a Hospital-A Pilot Evaluation Study

The progressive ageing of the working population and the increase in related chronic diseases tend to affect working capacity. The aim of this study was to evaluate a Workplace Disability Management Program (WDMP) within a pediatric hospital. Absenteeism due to healthcare workers’ (HCWs) pre- and post- WDMP and the related costs were used for the program evaluation. The Return on Investment (ROI), the Break-Even Analysis (BEA) and the value of the average annual productivity of HCWs who took advantage of the Disability Management (DM) interventions to assess the economic impact of the program, were also used. The HCWs enrolled in the program were 131 (approximately 4% of hospital staff), of which 89.7% females and with an average age of 50.4 years (SD ± 8.99). Sick leave days of the HCWs involved decreased by 66.6% in the year following the end of WDMP compared to the previous one (p < 0.001). The total estimated cost reduction of absenteeism is 427,896€ over a year. ROI was equal to 27.66€. BEA indicated that the break-even point was reached by implementing the program on 3.27 HCWs. The program evaluation demonstrated the particular effectiveness of the implemented WDMP model, acting positively on the variables that affect productivity and the limitation to work.

Sleep Health Promotion in the Workplace

Poor sleep and sleepiness in the workplace are associated with accidents. A workplace sleep health promotion program was implemented in an Italian police unit. Of the 242 police officers in the unit, 218 (90%) agreed to take part in the program. A crossover trial was made in which the police officers were divided into two groups that performed sleep health promotion activities in the first and second year, respectively. The first group of officers showed significant sleep improvements at the end of the first year, while the second group had similar or worse parameters than at baseline. At follow-up, a significant improvement in the quantity and quality of sleep was reported in both groups. Sleep improvements at follow-up were associated with a marked reduction in the frequency of accidents at work and near-misses. Before the intervention, sleepiness was the best predictor of injuries (aOR 1.220; CI95% 1.044–1.426) and near-misses (aOR 1.382; CI95% 1.182–1.615). At follow-up, when sleep conditions had improved, insomnia symptoms were the most significant predictors of work accidents (aOR 13.358; CI95% 2.353–75.818). Sleep health promotion can be useful in police officers.

Work limitations due to neck-shoulder pain and physical work demands in older workers: cross-sectional study

PURPOSE

Many older workers are working despite having neck-shoulder pain (NSP), which may give rise to work limitations due to pain, especially among those with high physical work demands. This study investigated the joint association of neck-shoulder pain intensity and physical work demands with work limitations among older workers.

METHODS

In SeniorWorkingLife, workers ≥ 50 years (n = 11,800) replied to questions about NSP intensity, work limitations due to pain, and physical activity demands at work. The odds ratio for having a higher level of work limitations due to pain in relation to neck-shoulder pain intensity and physical work demands were modeled using logistic regression controlled for various confounders.

RESULTS

The results showed that the neck-shoulder pain intensity was associated with work limitations in a dose-response fashion (p < 0.0001). Importantly, a significant interaction existed between neck-shoulder pain intensity and physical activity at work (p < 0.0001), e.g., 77% of workers with high pain and high work demands experienced work limitations due to the pain.

CONCLUSION

Higher neck-shoulder pain intensity and higher physical work demands-and particularly in combination-were associated with higher odds of work limitation due to pain among older workers. Thus, it seems especially important to accommodate work demands through a better work environment for these groups of workers.

Digital Health Coaching Programs Among Older Employees in Transition to Retirement: Systematic Literature Review

Background

The rapid increase of the aging population is pushing many national governments to reshape retirement legislation in order to extend older adults’ working life. Once retired, older adults can be invaluable resources for the community as family carers, as volunteers, or by returning to work. Healthy aging is one of the main conditions for being able to work longer and being active after retirement. The latter, indeed, represents a very sensitive life transition, which can entail psychological and social difficulties. Interventions for promoting older workers’ health and well-being and supporting the transition to retirement are on the top of the policy agenda of most European countries. Recently, computer-based and digital health interventions have been seen as promising means to reach this purpose.

Objective

This systematic literature review aimed to explore studies on digital health coaching programs for older workers that followed a user-centered design approach and evaluated their effectiveness in providing older adults with guidance for adopting a healthy lifestyle and being active in the community.

Methods

The search identified 1931 papers, and 2 relevant articles were selected by applying specific eligibility criteria.

Results

To our knowledge, only few digital health coaching programs have targeted the population of older workers to date; there is an insufficient number of studies on the efficacy of such programs. The results show the difficulties of assessing the efficacy of digital coaching itself and with respect to older employees. The 2 studies suggest that digital health programs for workplaces can improve various aspects of older employees’ well-being; however, they considered health mainly from a physical perspective and neglected contextual, social, psychological, and cultural factors that can influence older workers’ health and general well-being. Future digital health coaching programs should adopt the healthy aging paradigm as a multidimensional lens for interpreting the impact of eHealth technology on aging and retirement. The literature around this issue remains at an embryonic state, and this gap needs to be filled by further investigations that apply a user-centered approach for designing the technology, test innovative research methodologies, and adopt new technical solutions for high-quality interaction design.

Conclusions

Further digital health coaching programs aimed at supporting healthy and active living for older workers and retirees are necessary. The user-centered design approach is recommended in order to fully address the users’ health needs and the technological requirements throughout development. Moreover, the healthy aging perspective allows inclusion of physical, social, and psychological factors influencing the transition from work to retirement, as well as the experiences and interactions of individuals with the technology.

Does Dialogue Improve the Sustainable Employability of Low-Educated Employees? A Study Protocol for an Effect and Process Evaluation of "Healthy HR"

Background: There is a need to develop sustainable employability (SE) interventions that are better aligned to the needs of low-educated employees. This group needs to get a voice in intervention development and implementation. In this study, a dialogue-based approach is proposed consisting of an online step-by-step support toolkit for employers, "Healthy Human Resources" (HHR). When intervening, this toolkit enables and stimulates employers to have a continuous dialogue with their low-educated employees. By improving the employees' job control, HHR is aimed at cost-beneficially improving SE. This paper describes the protocol of the evaluation study to evaluate the effectiveness and implementation process of HHR on the SE of low-educated employees. Methods: The protocol of the evaluation study consists of: (1) an effect evaluation with a pretest-posttest design with a 1-year follow-up in five work organizations in the Netherlands deploying low-educated employees and with SE as the primary outcome and job control as the secondary outcome. The effect evaluation is expanded with a budget impact analysis; (2) a mixed-method process evaluation at 6 and 12 months after the start of HHR to evaluate the whole implementation process of HHR. This includes the experiences with HHR of various stakeholders, such as employees, human resource managers, and line managers. Discussion: The effect evaluation will give insight into the effects of HHR on the SE of low-educated employees. The process evaluation will provide insight into the underlying mechanisms of the (in) effectiveness of HHR. By improving dialogue, we hypothesize that HHR, through enhancing job control, will strengthen the SE of low-educated employees. Also for helping with tackling the socioeconomic health gap, if proven effective, the implementation of HHR on a wider scale can be recommended.

Do workplace health-promotion interventions targeting employees with poor health reduce sick-leave probability and disability rates?

Aims:

This study aimed to investigate whether introducing workplace health-promotion interventions targeting employees with health problems or reduced work ability affected overall sick leave and disability risk.

Methods:

The study population comprised data from an establishment survey from 2010 identifying who had introduced workplace health promotion (the intervention) linked to register data on all employees and their sickness absence and disability pension uptake from 2000 through 2010.

Results:

Interventions had moderate effects due to varying efficacy in different parts of the labour market. Intervention success was more likely among white-collar workers (e.g. in public administration) compared to blue-collar workers (e.g. in manufacturing), probably due to variations in both organisational and technological constraints. Effects were small among men and moderate among older workers, particularly among women. Overall, disability risk reduction was accompanied by an increase in sickness absence. Sometimes, sickness absence increased in groups with no change in disability risk, suggesting that presenteeism in one group may increase absenteeism in other groups.

Conclusions:

Introducing workplace health-promotion interventions may prolong work careers in some labour-market segments. Financial incentives for Norwegian establishments to continue offering workplace health-promotion interventions may be improved, given the current financial model for disability pension and sickness benefits.

Diet, physical activity, and emotional health: what works, what doesn't, and why we need integrated solutions for total worker health

Background

Current research advocates lifestyle factors to manage workers’ health issues, such as obesity, metabolic syndrome, and type II diabetes mellitus, among other things (World Health Organization (WHO) Obesity: preventing and managing the global epidemic, 2000; World Health Organization (WHO) Obesity and overweight, 2016), though little is known about employees’ lifestyle factors in high-stress, high turnover environments, such as in the long term care (LTC) sector.

Methods

Drawing on qualitative single-case study in Ontario, Canada, this paper investigates an under-researched area consisting of the health practices of health care workers from high-stress, high turnover environments. In particular, it identifies LTC worker’s mechanisms for maintaining physical, emotional, and social wellbeing.

Results

The findings suggest that while particular mechanisms were prevalent, such as through diet and exercise, they were often conducted in group settings or tied to emotional health, suggesting important social and mental health contexts to these behaviors. Furthermore, there were financial barriers that prevented workers from participating in these activities and achieving health benefits, suggesting that structurally, social determinants of health (SDoH), such as income and income distribution, are contextually important.

Conclusions

Accordingly, given that workplace health promotion and protection must be addressed at the individual, organizational, and structural levels, this study advocates integrated, total worker health (TWH) initiatives that consider social determinants of health approaches, recognizing the wider socio-economic impacts of workers’ health and wellbeing.

Developing a Health-Promotion Program Based on the Action Research Paradigm to Reduce Cardiovascular Disease Risk Factors among Blue Collar Workers

This study developed and evaluated a health management program based on the participant-centered concept of action research to reduce cardiovascular disease (CVD) risk factors among blue collar workers. Data from structured questionnaires completed by 32 workers in a small-to-medium sized workplace from September 2015 to October 2016 as well as participants’ anthropometrical (weight and waist) and biological (blood pressure, glucose, total cholesterol, triglyceride, high-density lipoprotein (HDL), and low-density lipoprotein (LDL) cholesterol) data were analyzed using paired t-test and Fisher’s exact test. To examine the longitudinal effect of the intervention, survival analysis and linear mixed model (LMM) were used. There was an improvement in participants’ self-regulation in maintaining health-promoting behaviors, body weight, blood pressure, and HDL cholesterol following the intervention. Furthermore, the effects of the health management program continued even after the program ended. These findings suggest that the health management program developed in this study could be effective in reducing CVD risk factors among workers in small-to-medium sized workplaces and should be applied to other small-to-medium sized workplaces to foster health-promoting behaviors.

Factors Predicting Voluntary and Involuntary Workforce Transitions at Mature Ages: Evidence from HILDA in Australia

The fast population ageing has generated and will continue to generate large social, economic and health challenges in the 21th century in Australia, and many other developed and developing countries. Population ageing is projected to lead to workforce shortages, welfare dependency, fiscal unsustainability, and a higher burden of chronic diseases on health care system. Promoting health and sustainable work capacity among mature age and older workers hence becomes the most important and critical way to address all these challenges. This paper used the pooled data from the longitudinal Household, Incomes and Labour Dynamics in Australia (HILDA) survey 2002–2011 data to investigate common and different factors predicting voluntary or involuntary workforce transitions among workers aged 45 to 64. Long term health conditions and preference to work less hours increased while having a working partner and proportion of paid years decreased both voluntary and involuntary work force transitions. Besides these four common factors, the voluntary and involuntary workforce transitions had very different underlying mechanisms. Our findings suggest that government policies aimed at promoting workforce participation at later life should be directed specifically to life-long health promotion and continuous employment as well as different factors driving voluntary and involuntary workforce transitions, such as life-long training, healthy lifestyles, work flexibility, ageing friendly workplace, and job security.

Psychosocial Risk Prevention in a Global Occupational Health Perspective. A Descriptive Analysis

This study aimed to find out which countries around the world require psychosocial hazards and workplace violence to be assessed by employers through a mandatory occupational risk assessment process and to compare the type of legislation between countries. We systematically searched the International Labour Office (ILO) “LEGOSH” database for documents published during the period between December 2017 and February 2018. The search included 132 countries, of which 23 were considered as developed and 109 as developing according to the United Nations. Our review showed that most countries (85, i.e., 64%) have not included mandatory psychosocial risk assessment and prevention in their national occupational safety and health legislation. Moreover, we found differences between developed and developing countries, showing that developed countries more frequently have legislative measures. Within developed countries, we also found differences between countries following the Scandinavian model of workplace health and safety culture and other countries. Moreover, in many countries, workplace violence was prohibited only if it involves an offence to moral or religious customs. In conclusion, the marked difference in psychosocial hazards and workplace violence regulations among countries leads to unequal levels of workers’ protection, with adverse effects on global health.

Barriers and facilitators to implementing workplace health and wellbeing services in the NHS from the perspective of senior leaders and wellbeing practitioners: a qualitative study

BACKGROUND

The National Health Service (NHS) seems appropriately placed to be an exemplar employer in providing effective and proactive workplace health and wellbeing services for its staff. However, NHS staff sickness absence costs an estimated £2.4 billion. Evidence suggests staff health and wellbeing services delivered in the NHS can improve health, productivity and sickness absence and yet the adoption of these services remains a challenge, with few examples nationally. This research aimed to explore the perceptions of NHS senior leaders and health and wellbeing practitioners regarding barriers and facilitators to implementing workplace health and wellbeing services for staff in the NHS.

METHODS

Semi-structured interviews were conducted with NHS staff, consisting of four senior leaders, four heads of department and three health and wellbeing practitioners in one region of the UK. Interviews were transcribed verbatim and analysed using thematic analysis.

RESULTS

Themes describe the experience of delivering workplace health and wellbeing services in the NHS, and barriers and facilitators to implementation from senior decision makers. Barriers to implementation of services include; a busy and pressurised environment, financial constraints and reluctance to invest in staff health and wellbeing. Barriers to staff engagement were also reported and include difficulty of access to health and wellbeing services and lack of time. Initiating services were facilitated by financial incentives, a supportive organisational structure and culture that takes a preventative, rather than reactive, approach to staff health and wellbeing. Facilitators to implementing health and wellbeing services include a coherent, strategic approach to implementation, effective communication and advertisement, being creative and innovative with resources and conducting a needs analysis and evaluation before, during and after implementation.

CONCLUSIONS

Barriers to the successful initiation and implementation of health and wellbeing services in the NHS are numerous and range from front-line logistical issues with implementation to high-level strategic and financial constraints. Adopting a strategic and needs-led approach to implementation and ensuring thorough staff engagement are amongst a number of factors that facilitate implementation and help overcome barriers to initiation of wellbeing programmes in the NHS. There is a need for a culture that supports staff health and wellbeing in the NHS.

A Cluster Randomized Controlled Trial of a Total Worker Health® Intervention on Commercial Construction Sites

This study evaluated the efficacy of an integrated Total Worker Health^® program, “All the Right Moves”, designed to target the conditions of work and workers’ health behaviors through an ergonomics program combined with a worksite-based health promotion Health Week intervention. A matched-pair cluster randomized controlled trial was conducted on ten worksites (five intervention (n = 324); five control sites (n = 283)). Worker surveys were collected at all sites pre- and post- exposure at one- and six-months. Linear and logistic regression models evaluated the effect of the intervention on pain and injury, dietary and physical activity behaviors, smoking, ergonomic practices, and work limitations. Worker focus groups and manager interviews supplemented the evaluation. After controlling for matched intervention and control pairs as well as covariates, at one-month following the ergonomics program we observed a significant improvement in ergonomic practices (B = 0.20, p = 0.002), and a reduction in incidences of pain and injury (OR = 0.58, p = 0.012) in the intervention group. At six months, we observed differences in favor of the intervention group for a reduction in physically demanding work (B = −0.25, p = 0.008), increased recreational physical activity (B = 35.2, p = 0.026) and higher consumption of fruits and vegetables (B = 0.87, p = 0.008). Process evaluation revealed barriers to intervention implementation fidelity and uptake, including a fissured multiemployer worksite, the itinerant nature of workers, competing production pressures, management support, and inclement weather. The All the Right Moves program had a positive impact at the individual level on the worksites with the program. For the longer term, the multi-organizational structure in the construction work environment needs to be considered to facilitate more upstream, long-term changes.

Psychological Capital Research: A Meta-Analysis and Implications for Management Sustainability

The purpose of this study is to conduct a wide-ranging meta-analytic review of empirical psychological capital studies in the management field. We conducted a meta-analysis on papers collected from the EBSCOhost and ProQuest databases. For comprehensive and extensive literature coverage, we also searched and compared the Journal Citation Report for the journals that referenced the most-cited articles (e.g., Journal of Organizational Behavior, Academy of Management Journal, etc.). A total of 81 published types of research were thoroughly selected and analyzed. The results revealed that, with different weighting, the following influencing factors have significant associations with psychological capital: organizational climate, organizational justice, authentic leadership, leader–member exchange, and occupational stress. Also, with different influencing weighting, psychological capital is confirmed to have impacts on job satisfaction, attitude, performance, organizational citizenship behavior, and undesirable behaviors. Implications for managerial sustainability are discussed.

Combined Before-and-After Workplace Intervention to Promote Healthy Lifestyles in Healthcare Workers (STI-VI Study): Short-Term Assessment

Health care workers (HCWs) are prone to a heavy psycho-physical workload. Health promotion programs can help prevent the onset of chronic and work-related diseases. The aim of the STI-VI ‘before-and-after’ study, with assessments scheduled at 6 and 12 months, was to improve the lifestyle of HCWs with at least one cardiovascular risk factor. A tailored motivational counseling intervention, focusing on dietary habits and physical activity (PA) was administered to 167 HCWs (53 males; 114 females). BMI, waist circumference, blood pressure, and cholesterol, triglyceride, and blood glucose levels were measured before and after the intervention. The 6-month results (total sample and by gender) showed a marked effect on lifestyle: PA improved (+121.2 MET, p = 0.01), and diets became more similar to the Mediterranean model (+0.8, p < 0.001). BMI dropped (−0.2, p < 0.03), and waist circumference improved even more (−2.5 cm; p < 0.001). Other variables improved significantly: total and LDL cholesterol (−12.8 and −9.4 mg/dL, p < 0.001); systolic and diastolic blood pressure (−4.4 and −2.5 mmHg, p < 0.001); blood glucose (−1.5 mg/dL, p = 0.05); and triglycerides (significant only in women), (−8.7 mg/dL, p = 0.008); but HDL cholesterol levels dropped too. If consolidated at 12 months, these results indicate that our intervention can help HCWs maintain a healthy lifestyle and work ability.