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Background: Healthcare workers report a higher incidence of depression than the general population. Work–family conflict is a risk factor, but the mechanisms explaining its association with depression are not well understood. This study examines the potential mediating and moderating role of sleep and decision latitude in translating work–family conflict into depression. Methods: In 2018, a cross-sectional survey was collected from healthcare workers ( n = 1,059) in five public sector facilities in the northeast United States. The survey included questions on participants’ work–family conflict, depression, sleep duration and disturbances, decision latitude, and other work environments and socio-demographic characteristics. Multivariable linear and Poisson regression modeling were used to examine associations among variables. Findings: There was a significant association between work–family conflict and depression (β = 2.70, p < .001). Sleep disturbances, although not short sleep duration, partially mediated this association. The association between work family–conflict and depression was stronger among workers with low decision latitude. Conclusions: Depression was prevalent among healthcare workers and was associated with work–family conflict. Sleep disturbances served as a significant mediator, while decision latitude modified the strength of the association. Application to Practice: Evidence-based interventions seeking to alleviate the effect of work–family conflict and improve healthcare workers’ mental health should consider promoting employee sleep quality and improving employees’ decision-making on the job.

Aging workers in manufacturing are at greater risk of workforce departure than in other sectors. Workers in manufacturing have a variety of job types. Some jobs require traditional kinds of intensive manual labor, but new technology now requires many workers to operate automated machines from computer workstations, resulting in different physical demands from traditional production jobs that can nonetheless contribute to musculoskeletal strain and decreased functional capacity. Musculoskeletal health (MSH) and perceived work ability (PWA) are relevant to departure decisions, yet studies rarely model these constructs simultaneously. We used the job demands-resources model to evaluate job/personal demands and resources as antecedents of MSH and PWA, and examine both as mediators of departure. Workers from six U.S. manufacturers completed surveys (N = 758). Most were white, male, married, and middle-aged (M = 47.2 years). Hypotheses were tested using multiple linear regression and structural equation modeling. MSH and PWA were modeled as latent variables, and all others as observed variables. MSH and PWA were impacted by different demands and resources. Job demands (computer-based) and personal resources (sleep quality, leisure-time walking) predicted MSH, and job resources (supervisor support) and personal resources (sleep surplus) predicted PWA. MSH mediated relations of computer-based job demands, sleep quality, and leisure-time walking with PWA. MSH and PWA were unrelated to departure, likely due to sampling limitations. Identifying upstream causes of MSH and PWA provides primary preventative points of intervention – such as reducing job demands and offering needed resources – that may improve the health and functioning of aging workers.

After a Design Team (DT) conducted a workforce health assessment of correctional supervisors, they selected sleep as an intervention priority, given its numerous health and work consequences. Existing workplace sleep interventions are designed with little worker input, but participatory solutions that incorporate workers' lived experiences and root causes of poor sleep may be more relevant, appropriate, and acceptable to end-users, resulting in better uptake.The DT met bi-monthly to complete the Intervention Design and Analysis Scorecard (IDEAS) tool to brainstorm interventions that address root causes of poor sleep, and evaluate, rank, and select interventions for implementation. We conducted a qualitative review of meeting notes and worksheets from each IDEAS step, and present our findings on root causes and prioritized solutions.The DT consisted of two university researchers and seven members of a correctional supervisors' union, with 5-9 participants attending each meeting. IDEAS Steps 1-5 were completed in eight meetings over six months. Root causes of poor sleep included mind/body and environmental disruptions, and insufficient time. Three solutions were proposed: training on sleep hygiene, meditation, and sleep debt management; a sleep-tracking smartphone app; and a shared overtime policy based on splitting one 8-hour shift between two supervisors.This is the first known application of IDEAS to address sleep, and targeting root causes may result in more efficacious interventions for sleep improvement. Moreover, because IDEAS guides DTs in selecting solutions with the greatest perceived health benefits, reach, cost-effectiveness, and feasibility, it may result in more successful implementation.

This cross-sectional study was conducted to examine the association between the direct and indirect effect of traumatic incident exposure at work on correctional supervisors’ experience of work-to-family conflict and depressive symptoms. The moderating role of coworker and supervisor social support was also examined. 156 correctional supervisors (i.e., lieutenants, captains, counselor supervisors) working in a Northeastern state participated in an online survey designed to assess perceptions of their work environment as well as health and family life. Structural equation modeling was used to conduct mediation and moderation analyses. Inmate assaults on inmates and staff were the most common exposures to work-related trauma among correctional supervisors. Correctional supervisors reported being more affected by traumatic incidents directed to self and/or peers (i.e., inmate assault on self/staff). The effect of traumatic incident exposure directed to inmates was associated with greater depressive symptoms for correctional supervisors [β = .31, p

Objectives Mental health disorders are a leading cause of work disability and while the psychosocial workplace environment plays a critical role, working time characteristics are also implicated. We sought to examine the association between working time characteristics and mental health in a cohort of two unionized, full-time worker populations, correctional supervisors, and transportation maintainers. Methods Using a cross-sectional study design, we surveyed workers on working time characteristics across seven domains including length of the shift, the intensity or proximity of sequential shifts, the time of day, and social aspects of work hours including predictability, variability, control, and free time. Burnout symptoms (Oldenburg Burnout Inventory) and depressive symptoms (eight-item Centers for Epidemiologic Studies Depression Scale) were assessed along with the psychosocial work environment and health behaviors. We used log-binomial regression models to estimate prevalence ratios and 95% confidence intervals after adjusting for age, gender, and company. Results A total of 318 workers were surveyed. The majority (72%) of workers reported a fixed shift. The prevalence of burnout symptoms was higher among workers reporting more frequent shift intensity (working 6 or more days in a row) (PR: 1.15, 95% CI: 1.01, 1.31; P = 0.04). Low psychological demands and high worker social support were associated with fewer burnout symptoms, independent of working time characteristics. The prevalence of depressive symptoms was higher in workers reporting more frequent unpredictable work (PR: 1.17, 95% CI: 1.01, 1.35; P = 0.04) and was lower among workers reporting increased schedule control (PR: 0.86, 95% CI: 0.77, 0.96; P = 0.01). Higher worker social support as well as sufficient sleep and adequate exercise were associated with fewer depressive symptoms, independent of working time characteristics. Conclusions Different working time characteristics were associated with work-related mental health (i.e. burnout) as well as general mental health (i.e. depressive symptoms). Work intensity was associated with the prevalence of burnout symptoms and the results suggest that the mechanism may be through the need for recovery from the psychosocial exposures of work. Both schedule control and predictability were associated with depressive symptoms and the results suggest that work-life imbalance and lack of recovery may be implicated. Comprehensive prevention policies that consider work organization along with the psychosocial work environment and work-life balance may help to improve workers’ mental health.

BACKGROUND: Transportation road maintenance and repair workers, or ‘maintainers’, are exposed to hazardous and variable noise levels and often rely on hearing protection devices (HPD) to reduce noise exposure levels. We aimed to improve upon HPD use as part of the HearWell program that used a Total Worker Health(®), participatory approach to hearing conservation. METHODS: Full-shift, personal noise sampling was performed during the routine task of brush cutting. Work activities and equipment were recorded and combined with 1-min noise measures to summarize personal noise exposure levels by equipment. Using noise monitoring results, HPD noise reduction ratings, and input from worker-based design teams, a noise hazard scheme was developed and applied to the task and equipment used during brush cutting. RESULTS: Average (standard deviation) and maximum L(eq) 1-minute, personal noise exposure levels recorded during brush cutting included chainsaws at 92.1 (7.6) and max of 111 dBA, leaf blowers at 91.2 (7.5) and max 107 dBA and wood chipper at 90.3 (7.3) and max of 104 dBA. The worker-designed noise hazard scheme breaks down noise exposures into one of three color bands and exposure ranges: red (over 105 dBA), orange (90–105 dBA), or yellow (85–90 dBA). The scheme simplifies the identification of noise levels, assessment of noise hazard and choice of appropriate hearing protection for workers. CONCLUSION: Combining noise exposure assessment with intervention development using participatory methods, we characterized noise exposure and developed an intervention to educate and assist in protecting workers as they perform noisy tasks.

A team of academics and unionized correctional supervisors collaborated to assess workforce health and determine intervention priorities using participatory methods and tools.Correctional supervisors took a web-based survey. Univariate and bivariate tests examined attitudes/behaviors, exposures, and outcomes most strongly associated with health; risk based on rank within chain-of-command; and health behaviors amenable to change. We used a voting process tool to prioritize intervention topics.Some health behaviors and outcomes were poor (89% overweight/ obese, 41% poor-quality sleep). We also found favorable health behaviors (annual check-ups) and psychosocial conditions (meaningful work). Some health risks (excessive overtime) were not amenable to change or resisted acknowledgment (poor mental health). The team voted to develop interventions on sleep, mental health, and obesity.Comprehensive health assessment informed the prioritization process, enabling the team to quickly reach consensus on intervention priorities.

Background Teachers have high rates of daily stress and the majority of available interventions are focused at the teacher-level. Yet, best practices in Total Worker Health® approaches indicate organization-level interventions identified using a participatory approach are most effective. We conducted an exploratory scale-out pilot study to examine the adoption of the Healthy Workplace Participatory Program (HWPP), an evidence-based, Total Worker Health approach to engage employees (e.g., teachers) and supervisory personnel (e.g., administrators) in the design and implementation of workplace well-being interventions within two elementary schools. Methods We evaluated the program both quantitatively and qualitatively collecting implementation outcome data (i.e., fidelity, acceptability, understanding, feasibility, system alignment) as well as data-driven adaptations using the Framework for Reporting Adaptations and Modifications-Expanded. Data from the first school informed scale-out adaptation of the HWPP intervention, HWPP-Education, within the second school. We compared implementation outcomes between Pilot Schools 1 and 2 to evaluate improvements in the adapted HWPP. Results Adaptations to HWPP program content and process were suggested to increase feasibility and contextual fit. Acceptability, understanding, and feasibility ratings showed statistically significant improvements comparing School 1 to School 2 which implemented the improved HWPP-Education. Furthermore, users reported adaptations including shorter meeting design and faster process were feasible within their work context. Conclusion This pilot study is the first attempt to scale out the HWPP to educators, and while not intended to confirm efficacy, it showed promising results for scale-out. Results from Pilot Schools 1 and 2 suggest systematic use of quantitative and qualitative implementation data can effectively inform scale-out efforts that increase critical outcomes such as fidelity, acceptability, understanding, feasibility, system alignment, and leader engagement as well as decrease the extent of system resources needed. As such, this scale-out process may be a feasible approach on which to base large-scale implementation efforts of the HWPP among educators.

Our objective was to pilot test HearWell, an intervention created to preserve hearing among highway maintainers, by using a participatory Total Worker Health® (TWH) approach to designing, implementing and evaluating interventions. Regional maintenance garages were randomized to control (n = 6), HearWell (n = 4) or HearWell Design Team (n = 2) arms. Maintainer representatives from the HearWell Design Team garages identified barriers to hearing health and collaborated to design interventions including a safety leadership training for managers, a noise hazard management scheme to identify noise levels and indicate the hearing protection device (HPD) needed, and a comprehensive HearWell training video and protocol. These worker-designed interventions, after manager input, were delivered to the HearWell Design Team and the HearWell garages. Control garages received standard industry hearing conservation training. Periodic surveys of workers in all 12 garages collected information on the frequency of HPD use and a new hearing climate measure to evaluate changes in behaviors and attitudes over the study period and following interventions. An intention-to-treat approach was utilized, differences and trends in group HPD use and hearing climate were analyzed using a mixed-effects model to account for repeated measures from individual participants. The HearWell Design Team maintainers reported the highest frequency of HPD use. Hearing climate improved in each group 6 months following intervention implementation, with the largest increase and highest value for the HearWell Design Team workers. The HearWell pilot intervention showed promising results in improving HPD use through a participatory TWH approach to hearing conservation. Furthermore, results suggest that employee participation in hearing conservation programs may be necessary for maximal effectiveness.

The effects of work and the conditions of employment on health behaviors and intermediate health conditions have been demonstrated, to the extent that these relationships should be addressed in efforts to prevent chronic disease. However, conventional health promotion practice generally focuses on personal risk factors and individual behavior change. In an effort to find solutions to the myriad of health challenges faced by the American workforce, the U.S. National Institute for Occupational Safety and Health (NIOSH) established the Total Worker Health® (TWH) program. Originally organized around the paradigm of integrating traditional occupational safety and health protections with workplace health promotion, TWH has evolved to a broader emphasis on workplace programs for enhancing worker safety, health, and well-being. Among the research programs and approaches developed by investigators at NIOSH Centers of Excellence for TWH and elsewhere, definitions of ‘integration’ in workplace interventions vary widely. There is no consensus about which organizational or individual outcomes are the most salient, how much to emphasize organizational contexts of work, or which program elements are necessary in order to qualify as ‘Total Worker Health’. Agreement about the dimensions of integration would facilitate comparison of programs and interventions which are self-defined as TWH, although diverse in content. The specific criteria needed to define integration should be unique to that concept—i.e. distinct from and additive to conventional criteria for predicting or evaluating the success of a workplace health program. We propose a set of four TWH-specific metrics for integrated interventions that address both program content and process: (i) coordination and interaction of workplace programs across domains; (ii) assessment of both work and non-work exposures; (iii) emphasis on interventions to make the workplace more health-promoting; and (iv) participatory engagement of workers in pivotal ways during intervention prioritization and planning to develop self-efficacy in addressing root causes, skill transfer, building program ownership, empowerment, and continuous improvement. Thus we find that integration requires organizational change, both to engage two managerial functions with different goals, legal responsibilities, and (often) internal incentives & resources, and also to orient the organization toward salutogenesis. Examples from research activity within the Center for the Promotion of Health in the New England Workplace illustrate how these criteria have been applied in practice.

OBJECTIVE This study examined how work and family demands affect depressive symptoms, and the mediating roles of work-to-family conflict and family-to-work conflict in a sample of correctional supervisors. METHODS Using a cross-sectional design, correctional supervisors working in a Northeastern state (n = 156) participated in an online survey. Structural equation modeling was used to examine direct and indirect effects between study variables. RESULTS Amount of overtime hours worked significantly predicted work-to-family conflict (β = 0.18, P

Correctional officers (COs) are exposed to a number of occupational stressors, and their health declines early in their job tenure. Interventions designed to prevent early decline in CO health are limited. This article describes the development, implementation, and evaluation of a one-year peer health mentoring program (HMP) guided by Total Worker Health® principles and using a participatory action research to collectively address worker safety, health, and well-being of newly hired COs. The HMP aimed to provide new COs with emotional and tangible forms of support during their first year of employment, including peer coaching to prevent early decline in physical fitness and health. The development and implementation of the HMP occurred across five main steps: (1) participatory design focus groups with key stakeholders; (2) adaptation of an existing mentoring handbook and training methods; (3) development of mentor–mentee recruitment criteria and assignment; (4) designing assessment tools; and (5) the initiation of a mentor oversight committee consisting of union leadership, corrections management, and research staff. Correctional employee engagement in the design and implementation process proved to be efficacious in the implementation and adaptation of the program by staff. Support for the HMP remained high as program evaluation efforts continued.

OBJECTIVE We sought to determine if leisure-time physical activity (LTPA) modified the adverse relationship between high job demands and nonrestorative sleep (NRS). METHODS We conducted a multivariate logistic regression analysis among workers from the cross-sectional National Healthy Worksite Project (n = 4683) using self-report Likert-Scale data on psychological and physical demands of jobs, LTPA and general health in relation to NRS. RESULTS Not engaging in LTPA was associated with NRS for workers with jobs at the lowest or highest levels of the physical demand scale (OR 1.64, 95% CI: 0.96-2.81, OR 2.06, 95% CI: 0.95-4.45; respectively) in comparison to those who met LTPA recommendations. When assessing psychological demands, poor general health was associated with NRS at all levels of the scale independent of LTPA. CONCLUSIONS LTPA may reduce NRS for workers with jobs at either extreme of physical demands.

UnlikeThe online version contains supplementary material available at 10.1007/s41542-022-00114-y.

Introduction The correctional workforce experiences persistent health problems, and interventions designed with worker participation show favorable outcomes. However, participatory intervention research often leaves workers out of the health needs assessment, the basis of interventions subsequently developed. This omission risks failure to detect factors contributing to the health and is less likely to result in primary prevention interventions. Methods Partnering with a correctional supervisors' union, we followed Schulz and colleagues' community-based participatory research (CBPR) methods for participatory survey design and used Healthy Workplace Participatory Program (HWPP) tools to develop a tailored survey to assess workforce health and contributing factors. Utilizing the HWPP Focus Group Guide, we generated key themes to adapt the HWPP All Employee Survey, a generic workforce health assessment, to become thorough and contextually-relevant for correctional supervisors. Results Content analysis of focus group data revealed 12 priority health concerns and contributors, including organizational culture, masculinity, work-family conflict, family support, trauma, positive job aspects, health literacy and efficacy, health/risk behaviors, sleep, obesity, and prioritizing work and income over health. Twenty-six measures were added to the generic survey, mainly health-related antecedents including knowledge, attitudes, norms, and motivation. Conclusion Findings yielded new insights about supervisors' lived experiences of work and health, and resulted in a customized workforce survey. CBPR methods and HWPP tools allowed us to identify health issues that we would not have detected with conventional methods, and provide opportunities for interventions that address root causes of poor health. We share challenges faced and lessons learned using CBPR with the correctional workforce.

How working hours are organized can have a substantial effect on workers' health. Using a questionnaire and cross-sectional study design, we evaluated the relationship between working time characteristics, job demands, and health behaviors on musculoskeletal symptoms among 316 Department of Transportation (N = 174) and Department of Corrections (N = 142) workers. Low schedule control was associated with neck/shoulder musculoskeletal symptoms (prevalence ratio: 1.20, 95% confidence interval: 1.06-1.34, p 0.01), and working long (48 hours per week) hours more frequently was associated with leg/foot musculoskeletal symptoms (prevalence ratio: 1.26 95% confidence interval: 1.06-1.50, p = 0.02). Some working time characteristics were associated with musculoskeletal symptoms, and should be taken into consideration as part of interventions to prevent musculoskeletal disorders and promote health of workers.

A substantial portion of breast cancer survivors are active in the workforce, yet factors that allow survivors to balance work with cancer management and to return to work are poorly understood. We examined breast cancer survivors' most valued/desired types of support in early survivorship.Seventy-six employed breast cancer survivors answered an open-ended survey question assessing the most valued/desired support to receive from healthcare providers during early survivorship to manage work and health. Cutrona's (Journal of Social and Clinical Psychology 9:3-14, 1990) optimal matching theory and House's (1981) conceptualization of social support types informed our analyses. Data were content-analyzed to identify themes related to support, whether needed support was received or not, and the types of healthcare providers who provided support.We identified six themes related to types of support. Informational support was valued and mostly received by survivors, but they expected more guidance related to work. Emotional support was valued but lacking, attributed mainly to providers' lack of personal connection and mental health support. Instrumental (practical) support was valued but received by a small number of participants. Quality of life support to promote well-being and functionality was valued and often received. Other themes included non-specific support and non-support.This study expands our understanding of how breast cancer survivors perceive work-related support from healthcare professionals. Findings will inform targeted interventions designed to improve the support provided by healthcare professionals.Breast cancer survivors managing work and health challenges may benefit by having their unmet support needs fulfilled.

BACKGROUND/OBJECTIVES: The correctional environment exposes nurses to unique physical and psychosocial work stressors, such as inmate violence and safety concerns. Nurses often experience short and poor sleep; however, the quantity and quality of sleep in this specialty practice group of nurses are underexplored. The study objective was to examine a wide range of work and health correlates of sleep quantity and quality in correctional nurses. METHODS: A Web-based survey was administered to nurses within a Northeastern State Correctional Health-care System, covering questions on sleep quantity and quality, working conditions, health outcomes, and work outcomes. RESULTS: Among the 89 correctional nurses who participated, 56.2% reported short sleep duration (≤6 hours/day) and 31.8% reported poor sleep quality. Multivariate Poisson regression modeling suggested that night shift (prevalence ratio [PR] = 1.95, p < 0.05) and single marital status (PR = 2.25, p < 0.05) were significantly associated with increased prevalence of short sleep duration, whereas none of the work and health variables were significantly associated with increased prevalence of poor sleep quality, after adjustment for sociodemographics and other covariates. CONCLUSION: Correctional nurses experience a high prevalence of short and poor sleep. Similar to previous studies, we found that short sleep duration was associated with night shift work. Interventions targeting work schedule remodeling (e.g., reduce the number of consecutive night shifts) and shift work coping mechanisms may promote sleep health of correctional nurses.

The stress of feeling rushed and busy are contemporary facts of life as evidenced by research on time pressure and overload. This is explained by conservation of resources theory which posits that ...

Correctional officers (COs) are exposed to a number of occupational stressors, and their health declines early in their job tenure. Interventions designed to prevent early decline in CO health are limited. This article describes the development, implementation, and evaluation of a one-year peer health mentoring program (HMP) guided by Total Worker Health® principles and using a participatory action research to collectively address worker safety, health, and well-being of newly hired COs. The HMP aimed to provide new COs with emotional and tangible forms of support during their first year of employment, including peer coaching to prevent early decline in physical fitness and health. The development and implementation of the HMP occurred across five main steps: (1) participatory design focus groups with key stakeholders, (2) adaptation of an existing mentoring handbook and training methods, (3) development of mentor–mentee recruitment criteria and assignment, (4) designing assessment tools, and (5) the initiation of a mentor oversight committee consisting of union leadership, corrections management, and research staff. Correctional employee engagement in the design and implementation process proved to be efficacious in the implementation and adaptation of the program by staff. Support for the HMP remained high as program evaluation efforts continued.

The translation of evidence-based health innovations into real-world practice is both incomplete and exceedingly slow. This represents a poor return on research investment dollars for the general public. U.S. funders of health sciences research (e.g., NIH, CDC, NIOSH) are increasingly calling for dissemination plans, and to a lesser extent for dissemination and implementation (D&I) research, which are studies that examine the effectiveness of D&I efforts and strategies and the predictors of D&I success. For example, rather than merely broadcasting information about a preventable hazard, D&I research in occupational safety and health (OSH) might examine how employers or practitioners are most likely to receive and act upon that information. We propose here that D&I research should be seen as a dedicated and necessary area of study within OSH, as a way to generate new knowledge that can bridge the research-to-practice gap. We present D&I concepts, frameworks, and examples that can increase the capacity of OSH professionals to conduct D&I research and accelerate the translation of research findings into meaningful everyday practice to improve worker safety and health.

Opportunities for people to recover from stress are insufficient, because demanding and excessive life activities leave little time for recovery. Downtime is a self-care behavior that can occur in any life domain (ie, work, home/family, leisure).Using survey data from a cross-section of 422 U.S. workers, we tested hypotheses regarding downtime as a buffer of the effects of time pressure and whether downtime's benefits were related to the domain in which it was taken, or influenced by perceived time control.In situations of high time pressure, work and home/family downtime were beneficial when time control was high, while relaxing leisure was beneficial when time control was low.Downtime is available whenever people recognize their need for recovery and respond by entering a state of physical relaxation and psychological detachment from stressors.

Eldercare demands (ECD) may result in stress when finite resources needed to fulfill life roles (i.e., family, work) become scarce. ECD may be acquired, continue over time, or be relinquished. They thus may represent acute stress (immediate, severe) or chronic stress (persistent, milder). Workers at six U.S. manufacturing companies completed surveys ( N = 520). ECD were operationalized as providing assistance to an adult aged 65+ years due to disability or illness. Workers were categorized into four ECD groups (persistent, relinquished, acquired, and none), and we examined the ECD groups’ association with person-centric and work-centric outcomes. Respondents with acquired ECD had worse mental health and greater depressive symptoms than those with none, and those with persistent ECD had greater work stress and family–work conflict than those with none. Findings suggesting that acute stress is more related to person-centric outcomes and chronic stress is more related to work-centric outcomes could inform development of tailored interventions.

Background The prevalence of musculoskeletal symptoms among custodians is high. We sought to compare musculoskeletal symptoms between female and male custodians and to explore how task might affect this relationship. Methods A cross-sectional study was performed among 712 custodians who completed a survey assessing upper extremity, back, and lower extremity musculoskeletal symptoms and exposure to cleaning tasks. Chi-square tests and logistic regression analyses were used to test for associations between gender, cleaning tasks, and musculoskeletal symptoms. Results Gender was significantly (P

BACKGROUND: Correctional Officers (COs) have among the highest injury rates and poorest health of all the public safety occupations. The HITEC-2 (Health Improvement Through Employee Control-2) study uses Participatory Action Research (PAR) to design and implement interventions to improve health and safety of COs. METHOD: HITEC-2 compared two different types of participatory program, a CO-only "Design Team" (DT) and "Kaizen Event Teams" (KET) of COs and supervisors, to determine differences in implementation process and outcomes. The Program Evaluation Rating Sheet (PERS) was developed to document and evaluate program implementation. RESULTS: Both programs yielded successful and unsuccessful interventions, dependent upon team-, facility-, organizational, state-, facilitator-, and intervention-level factors. CONCLUSIONS: PAR in corrections, and possibly other sectors, depends upon factors including participation, leadership, continuity and timing, resilience, and financial circumstances. The new PERS instrument may be useful in other sectors to assist in assessing intervention success. Am. J. Ind. Med. © 2016 Wiley Periodicals, Inc.© 2016 Wiley Periodicals, Inc. Language: en

Employees juggling eldercare and work report work–family conflicts and poor health-related outcomes, but little is known about eldercare demands (ECDs) in the context of competing demands in the manufacturing workforce. This study determines how ECDs vary by age, gender, income, and job category, and how ECDs and competing demands are associated with health-related and work-related outcomes, among manufacturing workers. Employees from six manufacturing companies completed questionnaires. ECDs were defined as providing assistance to an adult aged 65 and older due to disability or chronic illness; those with ECDs were asked how many care-hours per week and whether assistance included personal care. Workers over age 45 were more likely than younger workers to report ECDs. After adjusting for competing demands and socio-demographic characteristics, ECDs were associated with greater depressive symptoms and family-to-work conflict (FWC), providing 5 or more hours of eldercare weekly was associated with ...

A comparatively high prevalence of comorbidities among African-American/Blacks (AA/B) has been implicated in disparate survival in breast cancer. There is a scarcity of data, however, if this effect persists when accounting for the adverse triple-negative breast cancer (TNBC) subtype which occurs at threefold the rate in AA/B compared to white breast cancer patients. We reviewed charts of 214 white and 202 AA/B breast cancer patients in the NCI-SEER Connecticut Tumor Registry who were diagnosed in 2000–2007. We employed the Charlson Co-Morbidity Index (CCI), a weighted 17-item tool to predict risk of death in cancer populations. Cox survival analyses estimated hazard ratios (HRs) for all-cause mortality in relation to TNBC and CCI adjusting for clinicopathological factors. Among patients with SEER local stage, TNBC increased the risk of death (HR 2.18, 95 % CI 1.14–4.16), which was attenuated when the CCI score was added to the model (Adj. HR 1.50, 95 % CI 0.74–3.01). Conversely, the adverse impact of the CCI score persisted when controlling for TNBC (Adj. HR 1.49, 95 % CI 1.29–1.71; per one point increase). Similar patterns were observed in SEER regional stage, but estimated HRs were lower. AA/B patients with a CCI score of ≥3 had a significantly higher risk of death compared to AA/B patients without comorbidities (Adj. HR 5.65, 95 % CI 2.90–11.02). A lower and nonsignificant effect was observed for whites with a CCI of ≥3 (Adj. HR 1.90, 95 % CI 0.68–5.29). comorbidities at diagnosis increase risk of death independent of TNBC, and AA/B patients may be disproportionately at risk.

Background HITEC 2 (Health Improvement through Employee Control 2) is the follow-up to HITEC, a participatory action research (PAR) program that integrates health and work conditions interventions designed by the workforce. HITEC 2 compares intervention programs between two correctional sites, one using a pure workforce level design team and the other using a more structured and time delineated labor-management kaizen effectiveness team. Methods HITEC 2 utilizes a seven step participatory Intervention Design and Analysis Scorecard (IDEAS) for planning interventions. Consistent with PAR, process and intervention efficacy measures are developed and administered through workforce representation. Results Participation levels, robustness of participatory structures and sophistication of interventions have increased at each measured interval. Health comparisons between 2008 and 2013 showed increased hypertension, static weight maintenance, and increased ‘readiness to change’. Conclusions The PAR approaches are robust and sustained. Their long-term effectiveness in this population is not yet clear.

BACKGROUND: It is important to understand workplace factors including safety climate that influence hearing protection device (HPD) use. We sought to characterize and investigate the association between HPD use, safety climate, and hearing climate, a new climate measure specific to hearing. METHODS: Using a participatory, Total Worker Health® approach, a survey was developed and distributed among transportation ‘maintainers’ who perform road maintenance and repair. A new hearing climate measure was designed by adapting a safety climate measure. HPD use was assessed by asking workers how often they wear HPD while in noise. The differences in safety climate and hearing climate were compared by frequency of HPD use using ANOVA. Log binomial regression models were used to identify if safety climate and hearing climate predict the prevalence of HPD use. RESULTS: Among 166 maintainers, 54% reported always or almost always wearing HPD (high frequency). As compared to low frequency, high frequency HPD users reported a statistically significant higher safety climate (mean (std) of 3.94(0.65) versus 3.64 (0.65), p=0.004) and hearing climate (mean (std) of 3.78 (0.75) versus 3.38 (0.57), p=0.003). Hearing climate (p=0.03), but not safety climate (p=0.40), was a statistically significant predictor of increased prevalence of HPD use. CONCLUSIONS: Hearing climate predicts frequency of HPD use and may be a useful measure when assessing and improving hearing conservation programs. Results from this study provide baseline, pre-intervention hearing climate and HPD use frequencies that are expected to increase subsequent to the implementation of a hearing health intervention.

The correctional environment exposes registered nurses to unique occupational health hazards including, but not limited to, an increased risk for workplace violence. Gender role expectations regarding femininity and masculinity may influence occupational exposures and outcomes differently. Risk comparisons between male and female registered nurses working in correctional settings, have been minimally examined. With the proportion of male registered nurses working in corrections higher than that of nurses working in other healthcare sectors, and with the increasing number of males entering the nursing workforce in general, it is important to characterize and understand occupational exposures and outcomes of male and female registered nurses, especially those working in correctional settings.This paper aims to describe and compare sex and gender role differences in occupational exposures and work outcomes among correctional registered nurses.A cross-sectional web-based survey using Qualtrics was administered to registered nurses working in a northeastern correctional healthcare system between June and October 2016. The survey was composed of 71 items from the CPH-NEW Healthy Workplace All Employee Survey, Assessing Risk of Exposure to Blood and Airborne Pathogens and General Health Survey, Bem Sex Role Inventory-Short Form (BSRI-SF), and the Negative Acts Questionnaire-Revised.Of 95 registered nurse participants, 75% were female with the highest percentage identified as belonging to the feminine group (37%), while the highest percentage of male participants were identified as belonging to the androgynous group (33%). Females worked primarily on the first shift, while males tended to work the second and third shifts (P0.05). Over one third of all participants (37%) reported having experienced a sharps-related injury and having been exposed to blood-borne pathogens and body fluids within the previous 2-5 years. The majority of the participants (95%) reported being at risk for workplace violence and having been victims of workplace violence perpetrated by an inmate. Significant gender differences (P0.0001) were noted in the bullying exposure with androgynous nurses having higher occasional bullying. There was a marginal difference in burnout for females (M = 6.8, SD = 2.1) and males (M = 5.8, SD = 1.9, P = 0.05).Effective interventions are needed to address the sex and gender role-based differences in bullying exposure and burnout in order to promote the overall health and well-being of correctional registered nurses.

Introduction Corrections officers in state and federal prisons are faced with physical and psychosocial work demands that create challenges for maintaining high levels of workability, health and personal well-being. Furthermore, features of correctional work design, including around-the-clock operations and routine pressure to participate in overtime work may have additional consequences for health and retention of an ageing correctional workforce. In this study, we examined the implications of shift work and extended work hours for officers’ ability to maintain workability, health, and well-being in the face of stressful work demands, with attention focused on officer age (chronological age and psychological age) as a risk variable for increased negative outcomes. Methods As part of a Total Worker Health intervention study, corrections officers at a state correctional system in the northeastern USA participated in Wave 1 (n=335) or Wave 2 (n=260) of a survey that assessed physical and psychosocial work demands, work schedules, and several aspects of personal health and well-being. ANCOVA and moderated multiple regression analyses were used to examine the interactive effects of work schedule and age on relationships between work demands and worker health and well-being. An additional data collection in the same correctional system has recently been completed and will form the basis for follow-up analyses. Results Initial findings indicate that corrections officers in this sample are at risk of several negative physical and mental health outcomes (e.g., obesity, depressive symptoms, burnout). Psychosocial features of corrections work, including work schedules, interacted with correctional officer age, with stronger negative consequences for several aspects of personal health and well-being among chronologically and psychologically older officers. Conclusion In the face of an ageing corrections workforce, our findings suggest that particular attention should be paid to interventions that mitigate the impact of nightwork and overtime on the health and well-being of older officers.

Background A prospective study directed to musculoskeletal health in the manufacturing workforce. Methods A 36-month longitudinal study using mixed method; surveys with work and non-work psychosocial variables, physiologic measurements physical performance, interviews and focus groups, and direct observation of work activity. Results Changing economic conditions introduced barriers requiring recruiting a larger number of study sites. Study adherence was unexpectedly high. Coincident with their economic concerns, participants perceived an increase in workplace stress, but not physical demand. New instruments were added to assess economic effects on retirement planning and the physical and emotional costs of caregiving responsibilities. Conclusions The economic conditions required adaptive alterations in design due to workforce volatility but presented opportunities for studying the link between working conditions and health. Nevertheless, study size expectations were met through an adaptive approach that suggests a potential effect of the economy on health and well-being. Am. J. Ind. Med. 58:138–151, 2015. © 2015 Wiley Periodicals, Inc.

Correctional employees exhibit elevated obesity rates. This study examines interrelations among health behaviors, health climate, body mass index (BMI), and work schedule.Using survey results from correctional supervisors (n = 157), mediation and moderated-mediation analyses were performed to examine how health behaviors explain relationships between obesity, work health climate (WHC) and family health climate (FHC), and work schedule.Over 85% of the sample was overweight/obese (mean BMI = 30.20). Higher WHC and FHC were associated with lower BMI, mediated by nutrition, and physical activity. The interaction effect between health behavior and work schedule revealed a protective effect on BMI. Overtime shift work may share a relationship with BMI.Findings may have implications for reexamining organizational policies on maximum weekly overtime in corrections. They provide direction for targeted obesity interventions that encourage a supportive FHC and promote healthy behaviors among supervisors working overtime.

Objective This study examined associations among health behaviors, psychosocial work factors, and health status. Methods Correctional supervisors (n = 157) completed a survey that assessed interpersonal and organizational views on health. Chi-square and logistic regressions were used to examine relationships among variables. Results Respondents had a higher prevalence of obesity and comorbidities compared with the general US adult population. Burnout was significantly associated with nutrition, physical activity, sleep duration, sleep quality, diabetes, and anxiety/depression. Job meaning, job satisfaction, and workplace social support may predict health behaviors and outcomes. Conclusions Correctional supervisors are understudied and have poor overall health status. Improving health behaviors of middle-management employees may have a beneficial effect on the health of the entire workforce. This paper demonstrates the importance of psychosocial work factors that may contribute to health behaviors and outcomes.

The prevalence of musculoskeletal symptoms among custodians is high. We sought to compare musculoskeletal symptoms between female and male custodians and to explore how task might affect this relationship.A cross-sectional study was performed among 712 custodians who completed a survey assessing upper extremity, back, and lower extremity musculoskeletal symptoms and exposure to cleaning tasks. Chi-square tests and logistic regression analyses were used to test for associations between gender, cleaning tasks, and musculoskeletal symptoms.Gender was significantly (P 0.05) associated with musculoskeletal symptoms in χ(2) tests and multivariate analyses. The prevalence ratio of symptoms among women was roughly 50% higher than men, regardless of the tasks that workers performed.The prevalence of musculoskeletal symptoms differed for female and male custodians and appeared to be consistent across a range of job tasks. Am. J. Ind. Med. 59:841-852, 2016. © 2016 Wiley Periodicals, Inc.

Correctional Officers (COs) have among the highest injury rates and poorest health of all the public safety occupations. The HITEC-2 (Health Improvement Through Employee Control-2) study uses Participatory Action Research (PAR) to design and implement interventions to improve health and safety of COs.HITEC-2 compared two different types of participatory program, a CO-only "Design Team" (DT) and "Kaizen Event Teams" (KET) of COs and supervisors, to determine differences in implementation process and outcomes. The Program Evaluation Rating Sheet (PERS) was developed to document and evaluate program implementation.Both programs yielded successful and unsuccessful interventions, dependent upon team-, facility-, organizational, state-, facilitator-, and intervention-level factors.PAR in corrections, and possibly other sectors, depends upon factors including participation, leadership, continuity and timing, resilience, and financial circumstances. The new PERS instrument may be useful in other sectors to assist in assessing intervention success. Am. J. Ind. Med. 59:897-918, 2016. © 2016 Wiley Periodicals, Inc.

Acknowledging that there is diversity in the nature of work arrangements among the ranks of the self-employed, the authors sought to achieve a better understanding of work–family conflict among self-employed workers by using cognitive appraisal theory as a framework (Lazarus & Folkman, 1984) to consider the roles that both situation (work arrangement and number of hours worked) and person (preferred number of hours worked) factors play in predicting work-to-family conflict. Empirical data drawn from the 1997 and 2002 versions of the National Study of the Changing Workforce was used to test hypotheses. Results from both datasets indicated that small business owners (SBOs) were found to work significantly more hours than self-employed independents (SEIs) and that increased work hours were related to an increase in reported work-to-family conflict. In addition, preferred number of hours worked moderated the negative affect that number of work hours had on work-to-family conflict, although the form of the moderation differed between datasets. Theoretical and practical implications of the results are discussed in light of the clear differences that were found amongst members of the self-employed workforce.

The experience of time has been posited as an important predictor of work-family conflict; however, few studies have considered subjective and objective aspects of time conjointly. This study examined the reported number of hours dedicated to work and family as indices of objective aspects of time, and perceived time pressure (in the work and family domains respectively) as an important feature of the subjective nature of temporal experiences within the work-family interface. Results indicate that the stress of having insufficient time to fulfill commitments in one domain (i.e., perceived time pressure) predicts work-family conflict, and that perceived time pressures predict the amount of time allocated to a domain. Additionally, findings suggest that domain boundaries are not symmetrical, with work boundaries being more rigidly constructed than family boundaries. Work-to-family and family-to-work conflict were generally related to overall health, turnover intentions, and work performance, as expected.

Background Effective workplace interventions that consider the multifactorial nature of obesity are needed to reduce and prevent obesity among adults. Furthermore, the factors associated with obesity may differ for workers across age groups. Therefore, the objective of this study was to identify demographic, health-related, and work-related factors associated with baseline and changes in body mass index (BMI) and body fat percentage (BFP) and among Connecticut manufacturing workers acrossage groups. Methods BMI and BFPof 758 workers from six Connecticut manufacturing companies were objectively measuredat two time points approximately 36 months apart. Demographic, health-related, and work-related factors wereassessed via questionnaire. All variables were included in linear regression models to identify factors associated with baseline and changes in BMI and BFP for workers in 3 age groups: 55 years (28 %). Results There were differences in baseline and changes in BMI and BFP among manufacturing workers across age groups. Being interested in changing weight was significantly (p 55 year age category. Few factors were associated with change in BMI or BFP across any age category. Conclusions Among manufacturing workers, we identified associations between individual, health-related, and work-related factors and baseline BMIand BFP that differed by age. Such results support the use of strategies tailored to the challenges faced by workers in specific age groups rather than adopting a one size fits all approach. Effective interventions should consider a full range of individual, health-related, and work-related factors. More work must be done to identify factors or strategies associated with changes in obesity over time.

Background Two of the current methodological barriers to implementation science efforts are the lack of agreement regarding constructs hypothesized to affect implementation success and identifiable measures of these constructs. In order to address these gaps, the main goals of this paper were to identify a multi-level framework that captures the predominant factors that impact implementation outcomes, conduct a systematic review of available measures assessing constructs subsumed within these primary factors, and determine the criterion validity of these measures in the search articles. Method We conducted a systematic literature review to identify articles reporting the use or development of measures designed to assess constructs that predict the implementation of evidence-based health innovations. Articles published through 12 August 2012 were identified through MEDLINE, CINAHL, PsycINFO and the journal Implementation Science. We then utilized a modified five-factor framework in order to code whether each measure contained items that assess constructs representing structural, organizational, provider, patient, and innovation level factors. Further, we coded the criterion validity of each measure within the search articles obtained. Results Our review identified 62 measures. Results indicate that organization, provider, and innovation-level constructs have the greatest number of measures available for use, whereas structural and patient-level constructs have the least. Additionally, relatively few measures demonstrated criterion validity, or reliable association with an implementation outcome (e.g., fidelity). Discussion In light of these findings, our discussion centers on strategies that researchers can utilize in order to identify, adapt, and improve extant measures for use in their own implementation research. In total, our literature review and resulting measures compendium increases the capacity of researchers to conceptualize and measure implementation-related constructs in their ongoing and future research.

It has been said that in the course of our lives, we spend more time working than doing any other activity except sleeping. Therefore, it stands to reason that the ways in which we spend that enormous amount of our time (i.e., what we do for work, how we carry out our work tasks, when and how long we work, with whom we work, the environment in which we work, and how we feel about our work) are powerful factors influencing our experience of daily living.