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Using Total Worker Health® to Advance Worker Health and Safety
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Using Total Worker Health® to Advance Worker Health and Safety

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Occupational Safety and Health".

Deadline for manuscript submissions: closed (31 January 2019) | Viewed by 165827

Printed Edition Available!
A printed edition of this Special Issue is available here.

Special Issue Editors

Dr. Diane Rohlman

E-Mail Website
Guest Editor
Department of Occupational and Environmental Health, College of Public Health, University of Iowa, 145 N. Riverside Drive, 100 CPHB, Iowa City, IA 52242, USA
Interests: neurotoxic effects and neurological disorders in humans exposed to chemical and other agents; impaired populations exposed to workplace hazards; adverse effects of pesticide exposure on neurobehavioral performance
Dr. Kevin M. Kelly

E-Mail Website
Guest Editor
Department of Anthropology, University of Iowa, 114 Macbride Hall, Iowa City, IA 52242, USA
Interests: biological anthropology; medical anthropology; total worker health; environmental health; occupational health; population health; mixed methods
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

It is now recognized that aspects of the workplace (scheduling, shift work, physically-demanding work, chemical exposures), not only increase the risk of injury and illness, but also impact health behaviours (smoking, physical activity) and health outcomes (sleep disorders and fatigue, obesity, musculoskeletal disorders). In turn, ill health and chronic conditions can affect performance at work, increasing risk for injury, absenteeism, and reduced productivity. In the past few decades, programs that expand the traditional focus of occupational safety and health to consider non-traditional work-related sources of health and well-being have been shown to be more effective than programs that address these issues separately. This Total Worker Health approach has been recognized by the National Institute for Occupational Safety and Health as a method for protecting the safety and health of workers, while also advancing the overall well-being of these workers by addressing the conditions of work. This Special Issue is devoted to research “Advancing Worker Health and Safety” in the sense of Total Worker Health®. We welcome the submission of manuscripts presenting original basic and/or applied research relevant to program, policies or practices advancing holistic approaches to worker well-being. Themes may include, but are not limited to, the organization and design of the healthy physical and social work environments, innovative strategies for improving worker well-being, novel methods for exposing underlying occupational causes of chronic disease. The keywords listed below, as well as the issues identified in the text above, suggest some of the many relevant topics.

Dr. Diane Rohlman
Dr. Kevin M. Kelly
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Work design
  • Workforce demographics
  • Work organization
  • Work stress
  • Globalization
  • Safety and stress
  • Precarious work
  • Work-life continuum
  • Human factors

Published Papers (23 papers)

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18 pages, 335 KiB  
Article
Understanding the Role of Academic Partners as Technical Assistance Providers: Results from an Exploratory Study to Address Precarious Work
by Tessa Bonney, Christina Welter, Elizabeth Jarpe-Ratner and Lorraine M. Conroy
Int. J. Environ. Res. Public Health 2019, 16(20), 3903; https://doi.org/10.3390/ijerph16203903 - 15 Oct 2019
Cited by 6 | Viewed by 2664
Abstract
Universities may be well poised to support knowledge, skill, and capacity-building efforts to foster the development of multi-level interventions to address complex problems. Researchers at the University of Illinois at Chicago (UIC) engaged organizations interested in developing policy- and systems-level initiatives to address [...] Read more.
Universities may be well poised to support knowledge, skill, and capacity-building efforts to foster the development of multi-level interventions to address complex problems. Researchers at the University of Illinois at Chicago (UIC) engaged organizations interested in developing policy- and systems-level initiatives to address the drivers of precarious work in a six-meeting Action Learning (AL) process, in which the researchers served as technical assistance (TA) providers focused on facilitating learning and promoting critical thinking among participants. This exploratory qualitative study examined the role, facilitators, challenges, and impacts of university facilitation in this context. A total of 22 individuals participated in this study, including UIC TA providers, content expert TA providers from labor-focused organizations, and TA recipients from health-focused organizations. Results from interviews and a focus group highlight the utility of a university connecting organizations from different disciplines that do not traditionally work together, and suggest that the TA provided by UIC helped participants think concretely about precarious work and ways in which their organizations might work collaboratively to bring about sustainable change. Findings from this study suggest that university facilitation using an AL approach may be effective in increasing knowledge to action. Full article
(This article belongs to the Special Issue Using Total Worker Health® to Advance Worker Health and Safety)
14 pages, 1079 KiB  
Article
Assessing Workplace Health and Safety Strategies, Trends, and Barriers through a Statewide Worksite Survey
by Ami Sedani, Derry Stover, Brian Coyle and Rajvi J. Wani
Int. J. Environ. Res. Public Health 2019, 16(14), 2475; https://doi.org/10.3390/ijerph16142475 - 11 Jul 2019
Cited by 9 | Viewed by 3937
Abstract
Chronic diseases have added to the economic burden of the U.S. healthcare system. Most Americans spend most of their waking time at work, thereby, presenting employers with an opportunity to protect and promote health. The purpose of this study was to assess the [...] Read more.
Chronic diseases have added to the economic burden of the U.S. healthcare system. Most Americans spend most of their waking time at work, thereby, presenting employers with an opportunity to protect and promote health. The purpose of this study was to assess the implementation of workplace health governance and safety strategies among worksites in the State of Nebraska, over time and by industry sector using a randomized survey. Weighted percentages were compared by year, industry sector, and worksite size. Over the three study periods, 4784 responses were collected from worksite representatives. Adoption of workplace health governance and planning strategies increased over time and significantly varied across industry sector groups. Organizational safety policies varied by industry sector and were more commonly reported than workplace health governance and planning strategies. Time constraints were the most common barrier among worksites of all sizes, and stress was reported as the leading employee health issue that negatively impacts business. Results suggest that opportunities exist to integrate workplace health and safety initiatives, especially in blue-collar industry sectors and small businesses. Full article
(This article belongs to the Special Issue Using Total Worker Health® to Advance Worker Health and Safety)
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17 pages, 798 KiB  
Article
Prospective Evaluation of Fidelity, Impact and Sustainability of Participatory Workplace Health Teams in Skilled Nursing Facilities
by Rajashree Kotejoshyer, Yuan Zhang, Marian Flum, Jane Fleishman and Laura Punnett
Int. J. Environ. Res. Public Health 2019, 16(9), 1494; https://doi.org/10.3390/ijerph16091494 - 27 Apr 2019
Cited by 6 | Viewed by 4481
Abstract
Organizational features of work often pose obstacles to workforce health, and a participatory change process may address those obstacles. In this research, an intervention program sought to integrate occupational safety and health (OSH) with health promotion (HP) in three skilled nursing facilities. Three [...] Read more.
Organizational features of work often pose obstacles to workforce health, and a participatory change process may address those obstacles. In this research, an intervention program sought to integrate occupational safety and health (OSH) with health promotion (HP) in three skilled nursing facilities. Three facilities with pre-existing HP programs served as control sites. The intervention was evaluated after 3–4 years through focus groups, interviews, surveys, and researcher observations. We assessed process fidelity in the intervention sites and compared the two groups on the scope of topics covered (integration), program impact, and medium-term sustainability. The intervention met with initial success as workers readily accepted and operationalized the concept of OSH/HP integration in all three intervention facilities. Process fidelity was high at first but diminished over time. At follow-up, team members in two intervention sites reported higher employee engagement and more attention to organizational issues. Two of the three control facilities remained status quo, with little OSH/HP integration. The intervention had limited but positive impact on the work environment and health climate: staff awareness and participation in activities, and organizational factors such as decision-making, respect, communication, and sharing of opinions improved slightly in all intervention sites. Resources available to the teams, management support, and changing corporate priorities affected potential program sustainability. Full article
(This article belongs to the Special Issue Using Total Worker Health® to Advance Worker Health and Safety)
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12 pages, 326 KiB  
Article
Influence of Work on Elevated Blood Pressure in Hispanic Adolescents in South Texas
by Eva M. Shipp, Sharon P. Cooper, Luohua Jiang, Amber B. Trueblood and Jennifer Ross
Int. J. Environ. Res. Public Health 2019, 16(7), 1096; https://doi.org/10.3390/ijerph16071096 - 27 Mar 2019
Cited by 6 | Viewed by 3101
Abstract
Literature supports an association between work and cardiovascular disease in adults. The objective of this study was to examine the relationship between current work status and elevated blood pressure in Hispanic adolescents. Participants were students in Hidalgo County, located along the Texas-Mexico border. [...] Read more.
Literature supports an association between work and cardiovascular disease in adults. The objective of this study was to examine the relationship between current work status and elevated blood pressure in Hispanic adolescents. Participants were students in Hidalgo County, located along the Texas-Mexico border. Participants enrolled in the cohort study in ninth grade with assessments completed once a year for up to three years. Participants completed a self-report survey, while staff measured height, weight, waist circumference, blood pressure, and were screened for acanthosis nigricans. A generalized linear regression model with a logit link function was constructed to assess current work status and elevated blood pressure. Of the 508 participants, 29% had elevated blood pressure, which was associated with being male and other chronic disease indicators (e.g., acanthosis nigricans, overweight/obesity). The mean probability for elevated blood pressure was higher among currently working adolescents compared to those who were not. Findings were statistically significant (p < 0.05) at baseline. The findings illustrate that a large proportion of adolescents along the Texas-Mexico border may have elevated blood pressure and that working may be associated with it. Subsequent research is needed to confirm these findings, as well as to identify the mechanism for how work may increase hypertension in adolescents. Full article
(This article belongs to the Special Issue Using Total Worker Health® to Advance Worker Health and Safety)
15 pages, 344 KiB  
Article
Caring for Workers’ Health: Do German Employers Follow a Comprehensive Approach Similar to the Total Worker Health Concept? Results of a Survey in an Economically Powerful Region in Germany
by Aileen Hoge, Anna T. Ehmann, Monika A. Rieger and Achim Siegel
Int. J. Environ. Res. Public Health 2019, 16(5), 726; https://doi.org/10.3390/ijerph16050726 - 28 Feb 2019
Cited by 13 | Viewed by 4833
Abstract
Similar to ‘Total Worker Health’ in the United States (USA), ‘Workplace Health Management’ in Germany is a holistic strategy to protect, promote, and manage employees’ health at the workplace. It consists of four subcategories. While the subcategories ‘occupational health and safety’ and ‘reintegration [...] Read more.
Similar to ‘Total Worker Health’ in the United States (USA), ‘Workplace Health Management’ in Germany is a holistic strategy to protect, promote, and manage employees’ health at the workplace. It consists of four subcategories. While the subcategories ‘occupational health and safety’ and ‘reintegration management’ contain measures prescribed by law, ‘workplace health promotion’ and ‘personnel development’ can be designed more individually by the companies. The present study focused on the current implementation of voluntary and legally required measures of the four subcategories, as well as companies’ satisfaction with the implementation. A total of N = 222/906 companies (small, medium, and big enterprises of one German county) answered a standardized questionnaire addressing the implementation of health-related measures, satisfaction with the implementation, and several company characteristics. In the subcategory ‘occupational health and safety’, 23.9% of the companies fulfilled all of the legally required measures, whereas in the category ‘reintegration management’, that rate amounted to 50.9%. There was a positive correlation between company size and the implementation grade, and as well between company size and the fulfilling of measures required by law. Companies tended to be more satisfied with higher implementation grades. Nevertheless, a surprisingly high proportion of the companies with poor implementation indicated satisfaction with the measures’ implementation. Full article
(This article belongs to the Special Issue Using Total Worker Health® to Advance Worker Health and Safety)
17 pages, 1721 KiB  
Article
Implementation of the Healthy Workplace Participatory Program in a Retail Setting: A Feasibility Study and Framework for Evaluation
by Jaime R. Strickland, Anna M. Kinghorn, Bradley A. Evanoff and Ann Marie Dale
Int. J. Environ. Res. Public Health 2019, 16(4), 590; https://doi.org/10.3390/ijerph16040590 - 18 Feb 2019
Cited by 14 | Viewed by 5320
Abstract
Participatory methods used in Total Worker Health® programs have not been well studied, and little is known about what is needed to successfully implement these programs. We conducted a participatory health promotion program with grocery store workers using the Healthy Workplace Participatory [...] Read more.
Participatory methods used in Total Worker Health® programs have not been well studied, and little is known about what is needed to successfully implement these programs. We conducted a participatory health promotion program with grocery store workers using the Healthy Workplace Participatory Program (HWPP) from the Center for the Promotion of Health in the New England Workplace. We recruited a design team made up of six line-level workers and a steering committee with management and union representatives; a research team member facilitated the program. Using a formal evaluation framework, we measured program implementation including workplace context, fidelity to HWPP materials, design team and steering committee engagement, program outputs, and perceptions of the program. The HWPP was moderately successful in this setting, but required a substantial amount of worker and facilitator time. Design team members did not have the skills needed to move through the process and the steering committee did not offer adequate support to compensate for the team’s shortfall. The evaluation framework provided a simple and practical method for identifying barriers to program delivery. Future studies should address these barriers to delivery and explore translation of this program to other settings. Full article
(This article belongs to the Special Issue Using Total Worker Health® to Advance Worker Health and Safety)
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10 pages, 511 KiB  
Article
Generalizability of Total Worker Health® Online Training for Young Workers
by Ashamsa Aryal, Megan Parish and Diane S. Rohlman
Int. J. Environ. Res. Public Health 2019, 16(4), 577; https://doi.org/10.3390/ijerph16040577 - 16 Feb 2019
Cited by 6 | Viewed by 5427
Abstract
Young workers (under 25-years-old) are at risk of workplace injuries due to inexperience, high-risk health behaviors, and a lack of knowledge about workplace hazards. Training based on Total Worker Health® (TWH) principles can improve their knowledge of and ability to identify hazards [...] Read more.
Young workers (under 25-years-old) are at risk of workplace injuries due to inexperience, high-risk health behaviors, and a lack of knowledge about workplace hazards. Training based on Total Worker Health® (TWH) principles can improve their knowledge of and ability to identify hazards associated with work organization and environment. In this study, we assessed changes to knowledge and behavior following an online safety and health training between two groups by collecting information on the demographic characteristics, knowledge, and self-reported behaviors of workplace health and safety at three different points in time. The participants’ age ranged from 15 to 24 years. Age adjusted results exhibited a significant increase in knowledge immediately after completing the training, although knowledge decreased in both groups in the follow-up. Amazon Marketplace Mechanical Turk (MTurk) participants demonstrated a greater increase in knowledge, with a significantly higher score compared to the baseline, indicating retention of knowledge three months after completing the training. The majority of participants in both groups reported that they liked the Promoting U through Safety and Health (PUSH) training for improving health and safety and that the training should be provided before starting a job. Participants also said that the training was interactive, informative and humorous. The participants reported that the PUSH training prepared them to identify and control hazards in their workplace and to communicate well with the supervisors and coworkers about their rights. Training programs based on TWH improves the safety, health and well-being of young workers. Full article
(This article belongs to the Special Issue Using Total Worker Health® to Advance Worker Health and Safety)
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18 pages, 332 KiB  
Article
Identifying Barriers and Supports to Breastfeeding in the Workplace Experienced by Mothers in the New Hampshire Special Supplemental Nutrition Program for Women, Infants, and Children Utilizing the Total Worker Health Framework
by Eric A. Lauer, Karla Armenti, Margaret Henning and Lissa Sirois
Int. J. Environ. Res. Public Health 2019, 16(4), 529; https://doi.org/10.3390/ijerph16040529 - 13 Feb 2019
Cited by 34 | Viewed by 8646
Abstract
Variations in the barriers and contributors to breastfeeding across industries have not been well characterized for vulnerable populations such as mothers participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Our study used the Total Worker Health Framework to [...] Read more.
Variations in the barriers and contributors to breastfeeding across industries have not been well characterized for vulnerable populations such as mothers participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Our study used the Total Worker Health Framework to characterize workplace factors acting as barriers and/or contributors to breastfeeding among women participating in the New Hampshire WIC. Surveys were collected from WIC mothers (n = 682), which asked about employment, industry, and workplace accommodation and supports related to breastfeeding in the workplace. We found workplace policy factors supporting breastfeeding (i.e., having paid maternity leave, other maternity leave, and a breastfeeding policy) varied by industry. Women in specific service-oriented industries (i.e., accommodation and retail) reported the lowest rates of breastfeeding initiation and workplace supports for breastfeeding and pumping. Further, how a woman hoped to feed and having a private pumping space at work were significantly associated with industry, breastfeeding initiation, and breastfeeding duration. A substantial portion of women reported being not sure about their workplace environment, policies, and culture related to breastfeeding. Additional studies with larger sample sizes of women participating in WIC are needed to further characterize the barriers to breastfeeding associated with specific industries. Full article
(This article belongs to the Special Issue Using Total Worker Health® to Advance Worker Health and Safety)
20 pages, 754 KiB  
Article
The Happy-Productive Worker Model and Beyond: Patterns of Wellbeing and Performance at Work
by José M. Peiró, Malgorzata W. Kozusznik, Isabel Rodríguez-Molina and Núria Tordera
Int. J. Environ. Res. Public Health 2019, 16(3), 479; https://doi.org/10.3390/ijerph16030479 - 06 Feb 2019
Cited by 41 | Viewed by 13884
Abstract
According to the happy-productive worker thesis (HPWT), “happy” workers perform better than “less happy” ones. This study aimed to explore the different patterns of relationships between performance and wellbeing, synergistic (i.e., unhappy-unproductive and happy-productive) and antagonistic (i.e., happy-unproductive and unhappy-productive), taking into account [...] Read more.
According to the happy-productive worker thesis (HPWT), “happy” workers perform better than “less happy” ones. This study aimed to explore the different patterns of relationships between performance and wellbeing, synergistic (i.e., unhappy-unproductive and happy-productive) and antagonistic (i.e., happy-unproductive and unhappy-productive), taking into account different operationalizations of wellbeing (i.e., hedonic vs. eudaimonic) and performance (i.e., self-rated vs. supervisors’ ratings). It also explored different demographic variables as antecedents of these patterns. We applied two-step cluster analysis to the data of 1647 employees. The results indicate four different patterns—happy-productive, unhappy-unproductive, happy-unproductive, and unhappy-productive—when performance is self-assessed, and three when it is assessed by supervisors. On average, over half of the respondents are unhappy-productive or happy-unproductive. We used multidimensional logistic regression to explain cluster membership based on demographic covariates. This study addresses the limitations of the HPWT by including both the hedonic and eudaimonic aspects of wellbeing and considering different dimensions and sources of evaluation. The “antagonistic” patterns identify employees with profiles not explicitly considered by the HPWT. Full article
(This article belongs to the Special Issue Using Total Worker Health® to Advance Worker Health and Safety)
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12 pages, 303 KiB  
Article
Association between Occupational Injury and Subsequent Employment Termination among Newly Hired Manufacturing Workers
by Nathan C. Huizinga, Jonathan A. Davis, Fred Gerr and Nathan B. Fethke
Int. J. Environ. Res. Public Health 2019, 16(3), 433; https://doi.org/10.3390/ijerph16030433 - 02 Feb 2019
Cited by 2 | Viewed by 2939
Abstract
Few longitudinal studies have examined occupational injury as a predictor of employment termination, particularly during the earliest stages of employment when the risk of occupational injury may be greatest. Human resources (HR) records were used to establish a cohort of 3752 hourly employees [...] Read more.
Few longitudinal studies have examined occupational injury as a predictor of employment termination, particularly during the earliest stages of employment when the risk of occupational injury may be greatest. Human resources (HR) records were used to establish a cohort of 3752 hourly employees newly hired by a large manufacturing facility from 2 January 2012, through 25 November 2016. The HR records were linked with records of employee visits to an on-site occupational health center (OHC) for reasons consistent with occupational injury. Cox regression methods were then used to estimate the risk of employment termination following a first-time visit to the OHC, with time to termination as the dependent variable. Analyses were restricted to the time period ending 60 calendar days from the date of hire. Of the 3752 employees, 1172 (31.2%) terminated employment prior to 60 days from date of hire. Of these, 345 terminated voluntarily and 793 were terminated involuntarily. The risk of termination for any reason was greater among those who visited the OHC during the first 60 days of employment than among those who did not visit the OHC during the first 60 days of employment (adjusted hazard ratio = 2.58, 95% CI = 2.12–3.15). The magnitude of effect was similar regardless of the nature of the injury or the body area affected, and the risk of involuntary termination was generally greater than the risk of voluntary termination. The results support activities to manage workplace safety and health hazards in an effort to reduce employee turnover rates. Full article
(This article belongs to the Special Issue Using Total Worker Health® to Advance Worker Health and Safety)
15 pages, 593 KiB  
Article
Trust in the Work Environment and Cardiovascular Disease Risk: Findings from the Gallup-Sharecare Well-Being Index
by Toni Alterman, Rebecca Tsai, Jun Ju and Kevin M. Kelly
Int. J. Environ. Res. Public Health 2019, 16(2), 230; https://doi.org/10.3390/ijerph16020230 - 15 Jan 2019
Cited by 6 | Viewed by 17974
Abstract
This study examined associations between trust, an important aspect of workplace social capital, with seven cardiovascular disease (CVD) risk factors (American Heart Association Life’s Simple 7 (LS7)): smoking, obesity, low physical activity, poor diet, diabetes, high cholesterol, and high blood pressure. Data are [...] Read more.
This study examined associations between trust, an important aspect of workplace social capital, with seven cardiovascular disease (CVD) risk factors (American Heart Association Life’s Simple 7 (LS7)): smoking, obesity, low physical activity, poor diet, diabetes, high cholesterol, and high blood pressure. Data are from the U.S. Gallup-Sharecare Well-Being Index (2010–2012), a nationally representative telephone survey of U.S. workers (n = 412,884). The independent variable was the response to a work environment (WE) question as to whether their supervisor always creates an open and trusting environment. Regression models were adjusted for demographic characteristics with each of the LS7 CVD risk factors as dependent variables. Twenty-one percent of workers reported that their supervisor did not create an open and trusting environment. Trust was associated with increased adjusted odds of having many of the LS7 CVD risk factors. Among those workers whose supervisor created a mistrustful environment, the odds ratios were greatest (>20%) for having four or more of the LS7 CVD risk factors. Full article
(This article belongs to the Special Issue Using Total Worker Health® to Advance Worker Health and Safety)
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13 pages, 301 KiB  
Article
Employee Stress, Reduced Productivity, and Interest in a Workplace Health Program: A Case Study from the Australian Mining Industry
by Tamara D. Street, Sarah J. Lacey and Klaire Somoray
Int. J. Environ. Res. Public Health 2019, 16(1), 94; https://doi.org/10.3390/ijerph16010094 - 31 Dec 2018
Cited by 19 | Viewed by 8680
Abstract
The Australian mining sector has an elevated industry prevalence of stress and high stress related productivity impairment costs. This study surveyed 897 employees from an Australian mining company to identify characteristics associated with: (a) high stress related productivity impairment costs; and (b) likelihood [...] Read more.
The Australian mining sector has an elevated industry prevalence of stress and high stress related productivity impairment costs. This study surveyed 897 employees from an Australian mining company to identify characteristics associated with: (a) high stress related productivity impairment costs; and (b) likelihood of stressed employees wanting stress management assistance at work. Groups associated with average annual productivity impairment costs in excess of $50,000 per employee included: permanent day shift employees; employees who reported being stressed at work most of the time; employees who reported being stress at work all of the time; and employees who were contemplating better managing their stress in the next 6 months. Overall, 52% of employees who identified as being in the contemplation stage of change for stress management and 52% of employees who experienced stress most of the time reported wanting stress assistance with stress. However, only 33% of stressed permanent day shift employees and 36% of employees who experienced stress all the time reported wanting stress assistance. To achieve a high return on investment when implementing workplace stress management programs in the mining industry, practitioners need to strategically target health promotion to engage stressed employees with high productivity impairment costs and low desire for stress management assistance. Full article
(This article belongs to the Special Issue Using Total Worker Health® to Advance Worker Health and Safety)
17 pages, 767 KiB  
Article
Four Wellbeing Patterns and their Antecedents in Millennials at Work
by Tariku Ayana Abdi, José M. Peiró, Yarid Ayala and Salvatore Zappalà
Int. J. Environ. Res. Public Health 2019, 16(1), 25; https://doi.org/10.3390/ijerph16010025 - 22 Dec 2018
Cited by 7 | Viewed by 6406
Abstract
Literature suggests that job satisfaction and health are related to each other in a synergic way. However, this might not always be the case, and they may present misaligned relationships. Considering job satisfaction and mental health as indicators of wellbeing at work, we [...] Read more.
Literature suggests that job satisfaction and health are related to each other in a synergic way. However, this might not always be the case, and they may present misaligned relationships. Considering job satisfaction and mental health as indicators of wellbeing at work, we aim to identify four patterns (i.e., satisfied-healthy, unsatisfied-unhealthy, satisfied-unhealthy, and unsatisfied-healthy) and some of their antecedents. In a sample of 783 young Spanish employees, a two-step cluster analysis procedure showed that the unsatisfied-unhealthy pattern was the most frequent (33%), followed by unsatisfied-healthy (26.6%), satisfied-unhealthy (24.8%) and, finally, the satisfied-healthy pattern (14.3%). Moreover, as hypothesized, discriminant analysis suggests that higher levels of job importance and lower levels of role ambiguity mainly differentiate the satisfied-healthy pattern, whereas overqualification and role overload differentiate, respectively, the unsatisfied-healthy and satisfied-unhealthy patterns. Contrary to our expectations, role conflict also characterizes the satisfied-unhealthy pattern. We discuss the practical and theoretical implications of these findings. Full article
(This article belongs to the Special Issue Using Total Worker Health® to Advance Worker Health and Safety)
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14 pages, 319 KiB  
Article
Challenging Cognitive Demands at Work, Related Working Conditions, and Employee Well-Being
by Sophie-Charlotte Meyer and Lena Hünefeld
Int. J. Environ. Res. Public Health 2018, 15(12), 2911; https://doi.org/10.3390/ijerph15122911 - 19 Dec 2018
Cited by 37 | Viewed by 6044
Abstract
In times of digitalized workplaces the extent of challenging cognitive demands at work is rising and employees increasingly have to manage new and unlearned tasks. Yet, these work characteristics have received little attention on how they relate to the worker’s well-being. Thus, we [...] Read more.
In times of digitalized workplaces the extent of challenging cognitive demands at work is rising and employees increasingly have to manage new and unlearned tasks. Yet, these work characteristics have received little attention on how they relate to the worker’s well-being. Thus, we analyze associations between cognitive work demands—also in interaction with other job characteristics—and indicators of employee well-being. The analyses are based on the BIBB/BAuA Employment Survey 2018, a cross-section that is representative for the German working population and covers approximately 20,000 employed individuals. Ordinary least squares (OLS) regressions suggest that cognitive demands are associated with a higher probability of feeling fatigued. In contrast, the results with respect to the employees’ self-rated health status and job satisfaction are ambiguous, depending on which cognitive demand is considered. Overall, the findings indicate that cognitive demands might be related to both resource and demand, depending on the individual resources of employees. Full article
(This article belongs to the Special Issue Using Total Worker Health® to Advance Worker Health and Safety)
19 pages, 331 KiB  
Article
From Research-to-Practice: An Adaptation and Dissemination of the COMPASS Program for Home Care Workers
by Ryan Olson, Jennifer A. Hess, Kelsey N. Parker, Sharon V. Thompson, Anjali Rameshbabu, Kristy Luther Rhoten and Miguel Marino
Int. J. Environ. Res. Public Health 2018, 15(12), 2777; https://doi.org/10.3390/ijerph15122777 - 07 Dec 2018
Cited by 10 | Viewed by 4724
Abstract
The COMmunity of Practice And Safety Support (COMPASS) program was developed to prevent injuries and advance the health and well-being of home care workers. The program integrates elements of peer-led social support groups with scripted team-based programs to help workers learn together, solve [...] Read more.
The COMmunity of Practice And Safety Support (COMPASS) program was developed to prevent injuries and advance the health and well-being of home care workers. The program integrates elements of peer-led social support groups with scripted team-based programs to help workers learn together, solve problems, set goals, make changes, and enrich their supportive professional network. After a successful pilot study and randomized controlled trial, COMPASS was adapted for the Oregon Home Care Commission’s training system for statewide dissemination. The adapted program included fewer total meetings (7 versus 13), an accelerated meeting schedule (every two weeks versus monthly), and a range of other adjustments. The revised approach was piloted with five groups of workers (total n = 42) and evaluated with pre- and post-program outcome measures. After further adjustments and planning, the statewide rollout is now in progress. In the adaptation pilot several psychosocial, safety, and health outcomes changed by a similar magnitude relative to the prior randomized controlled trial. Preliminary training evaluation data (n = 265) show high mean ratings indicating that workers like the program, find the content useful, and intend to make changes after meetings. Facilitating factors and lessons learned from the project may inform future similar efforts to translate research into practice. Full article
(This article belongs to the Special Issue Using Total Worker Health® to Advance Worker Health and Safety)
13 pages, 985 KiB  
Article
Larger Workplaces, People-Oriented Culture, and Specific Industry Sectors Are Associated with Co-Occurring Health Protection and Wellness Activities
by Aviroop Biswas, Colette N. Severin, Peter M. Smith, Ivan A. Steenstra, Lynda S. Robson and Benjamin C. Amick III
Int. J. Environ. Res. Public Health 2018, 15(12), 2739; https://doi.org/10.3390/ijerph15122739 - 04 Dec 2018
Cited by 8 | Viewed by 5013
Abstract
Employers are increasingly interested in offering workplace wellness programs in addition to occupational health and safety (OHS) activities to promote worker health, wellbeing, and productivity. Yet, there is a dearth of research on workplace factors that enable the implementation of OHS and wellness [...] Read more.
Employers are increasingly interested in offering workplace wellness programs in addition to occupational health and safety (OHS) activities to promote worker health, wellbeing, and productivity. Yet, there is a dearth of research on workplace factors that enable the implementation of OHS and wellness to inform the future integration of these activities in Canadian workplaces. This study explored workplace demographic factors associated with the co-implementation of OHS and wellness activities in a heterogenous sample of Canadian workplaces. Using a cross-sectional survey of 1285 workplaces from 2011 to 2014, latent profiles of co-occurrent OHS and wellness activities were identified, and multinomial logistic regression was used to assess associations between workplace demographic factors and the profiles. Most workplaces (84%) demonstrated little co-occurrence of OHS and wellness activities. Highest co-occurrence was associated with large workplaces (odds ratio (OR) = 3.22, 95% confidence interval (CI) = 1.15–5.89), in the electrical and utilities sector (OR = 5.57, 95% CI = 2.24–8.35), and a high people-oriented culture (OR = 4.70, 95% CI = 1.59–5.26). Promoting integrated OHS and wellness approaches in medium to large workplaces, in select industries, and emphasizing a people-oriented culture were found to be important factors for implementing OHS and wellness in Canadian organizations. Informed by these findings, future studies should understand the mechanisms to facilitate the integration of OHS and wellness in workplaces. Full article
(This article belongs to the Special Issue Using Total Worker Health® to Advance Worker Health and Safety)
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12 pages, 1249 KiB  
Article
New Burnout Evaluation Model Based on the Brief Burnout Questionnaire: Psychometric Properties for Nursing
by María del Carmen Pérez-Fuentes, María del Mar Molero Jurado, África Martos Martínez and José Jesús Gázquez Linares
Int. J. Environ. Res. Public Health 2018, 15(12), 2718; https://doi.org/10.3390/ijerph15122718 - 02 Dec 2018
Cited by 16 | Viewed by 7747
Abstract
Health care personnel are considered one of the worker sectors most exposed to heavier workloads and work stress. One of the consequences associated with the exposure to chronic stress is the development of burnout syndrome. Given that evaluating this syndrome requires addressing the [...] Read more.
Health care personnel are considered one of the worker sectors most exposed to heavier workloads and work stress. One of the consequences associated with the exposure to chronic stress is the development of burnout syndrome. Given that evaluating this syndrome requires addressing the context in which they are to be used, the purpose of this work was to analyze the psychometric properties and structure of the Burnout Brief Questionnaire (CBB), and to propose a more suitable version for its application to health professionals, and more specifically nurses. The final study sample was made up of 1236 working nursing professionals. An exploratory factorial analysis was carried out and a new model was proposed through a confirmatory factorial analysis. Thus, validation of the CBB questionnaire for nursing health care personnel showed an adequate discrimination of the items and a high internal consistency of the scale. With respect to the factorial analysis, four factors were extracted from the revised model. Specifically, these new factors, called job dissatisfaction, social climate, personal impact, and motivational abandonment, showed an adequate index of adjustment. Thus, the Brief Burnout Questionnaire Revised for nursing staff has favorable psychometric properties, and this model can be applied to all health care professionals. Full article
(This article belongs to the Special Issue Using Total Worker Health® to Advance Worker Health and Safety)
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22 pages, 533 KiB  
Article
Moral or Dirty Leadership: A Qualitative Study on How Juniors Are Managed in Dutch Consultancies
by Onno Bouwmeester and Tessa Elisabeth Kok
Int. J. Environ. Res. Public Health 2018, 15(11), 2506; https://doi.org/10.3390/ijerph15112506 - 09 Nov 2018
Cited by 12 | Viewed by 4878
Abstract
Professional service firms in Western Europe have a reputation for putting huge pressures on their junior employees, resulting in very long work hours, and as a consequence health risks. This study explores moral leadership as a possible response to the stigma of such [...] Read more.
Professional service firms in Western Europe have a reputation for putting huge pressures on their junior employees, resulting in very long work hours, and as a consequence health risks. This study explores moral leadership as a possible response to the stigma of such dirty leadership. We conducted semi-structured interviews with 12 consultant managers and with each one of their juniors, and found that managers put several pressures on their juniors; these pressures bring high levels of stress, lowered wellbeing and burnout. Society considers such a pressuring leadership style morally dirty. To counteract the experience of being seen as morally dirty, we found that consultant managers were normalizing such criticisms as commonly assumed in dirty work literature. However, they also employed several moral leadership tactics to counteract the negative consequences criticized in society. However, in addition to the well-known individual-level tactics, consultant managers and their juniors also reported moral leadership support at the organizational level, like institutionalized performance talks after every project, trainings, specific criteria for hiring juniors, and policies to recognize and compliment high performance. Still, we cannot conclude these moral leadership approaches are moral by definition. They can be used in an instrumental way as well, to further push performance. Full article
(This article belongs to the Special Issue Using Total Worker Health® to Advance Worker Health and Safety)
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16 pages, 837 KiB  
Article
Effect of a Job Demand-Control-Social Support Model on Accounting Professionals’ Health Perception
by José Joaquín Del Pozo-Antúnez, Antonio Ariza-Montes, Francisco Fernández-Navarro and Horacio Molina-Sánchez
Int. J. Environ. Res. Public Health 2018, 15(11), 2437; https://doi.org/10.3390/ijerph15112437 - 01 Nov 2018
Cited by 20 | Viewed by 8344
Abstract
The Job Demand-Control and Job Demand-Control-Support (JDCS) models constitute the theoretical approaches used to analyze the relationship between the characteristics of labor and occupational health. Few studies have investigated the main effects and multiplicative model in relation to the perceived occupational health of [...] Read more.
The Job Demand-Control and Job Demand-Control-Support (JDCS) models constitute the theoretical approaches used to analyze the relationship between the characteristics of labor and occupational health. Few studies have investigated the main effects and multiplicative model in relation to the perceived occupational health of professional accountants. Accountants are subject to various types of pressure in performing their work; this pressure influences their health and, ultimately, their ability to perform a job well. The objective of this study is to investigate the effects of job demands on the occupational health of 739 accountants, as well as the role of the moderator that internal resources (locus of control) and external resources (social support) have in occupational health. The proposed hypotheses are tested by applying different models of neural networks using the algorithm of the Extreme Learning Machine. The results confirm the relationship between certain stress factors that affect the health of the accountants, as well as the direct effect that the recognition of superiors in occupational health has. Additionally, the results highlight the moderating effect of professional development and the support of superiors on the job’s demands. Full article
(This article belongs to the Special Issue Using Total Worker Health® to Advance Worker Health and Safety)
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15 pages, 427 KiB  
Article
Total Worker Health: A Small Business Leader Perspective
by Janalee Thompson, Natalie V. Schwatka, Liliana Tenney and Lee S. Newman
Int. J. Environ. Res. Public Health 2018, 15(11), 2416; https://doi.org/10.3390/ijerph15112416 - 31 Oct 2018
Cited by 13 | Viewed by 4692
Abstract
Total Worker Health® (TWH) frameworks call for attention to organizational leadership in the implementation and effectiveness of TWH approaches. It is especially important to study this within in the small business environment where employees face significant health, safety, and well-being concerns and [...] Read more.
Total Worker Health® (TWH) frameworks call for attention to organizational leadership in the implementation and effectiveness of TWH approaches. It is especially important to study this within in the small business environment where employees face significant health, safety, and well-being concerns and employers face barriers to addressing these concerns. The purpose of this study was to gain a better understanding of how small business leaders perceive employee health, safety, and well-being in the context of their own actions. We conducted semi-structured interviews with 18 small business senior leaders and used a qualitative coding approach to analyze the transcripts to determine the frequency with which leaders discussed each code. When we asked leaders about their leadership practices for health, safety, and well-being, leaders reflected upon their business (65%), themselves (28%), and their employees (7%). Leaders rarely discussed the ways in which they integrate health, safety, and well-being. The interviews demonstrate that small business leaders care about the health of their employees, but because of the perceived value to their business, not to employees or themselves. Thus, they may lack the knowledge and skills to be successful TWH leaders. The present study supports a need for continued small business TWH leadership research. Full article
(This article belongs to the Special Issue Using Total Worker Health® to Advance Worker Health and Safety)
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20 pages, 791 KiB  
Article
A Cluster Randomized Controlled Trial of a Total Worker Health® Intervention on Commercial Construction Sites
by Susan E. Peters, Michael P. Grant, Justin Rodgers, Justin Manjourides, Cassandra A. Okechukwu and Jack T. Dennerlein
Int. J. Environ. Res. Public Health 2018, 15(11), 2354; https://doi.org/10.3390/ijerph15112354 - 25 Oct 2018
Cited by 29 | Viewed by 6271
Abstract
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 [...] Read more.
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. Full article
(This article belongs to the Special Issue Using Total Worker Health® to Advance Worker Health and Safety)
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13 pages, 950 KiB  
Article
It Doesn’t End There: Workplace Bullying, Work-to-Family Conflict, and Employee Well-Being in Korea
by Gyesook Yoo and Soomi Lee
Int. J. Environ. Res. Public Health 2018, 15(7), 1548; https://doi.org/10.3390/ijerph15071548 - 22 Jul 2018
Cited by 32 | Viewed by 6124
Abstract
Workplace bullying entails negative consequences on workers’ life. Yet, there is lack of research on workplace bullying in an Asian context. Moreover, less is known about the potential mechanisms linking workplace bullying and employee well-being. This study examined the associations between workplace bullying [...] Read more.
Workplace bullying entails negative consequences on workers’ life. Yet, there is lack of research on workplace bullying in an Asian context. Moreover, less is known about the potential mechanisms linking workplace bullying and employee well-being. This study examined the associations between workplace bullying and Korean employees’ well-being (quality of life, occupational health) and whether the associations were mediated by work-to-family conflict. Cross-sectional data came from 307 workers in South Korea who were employed in healthcare, education, and banking industries. Analyses adjusted for industry, age, gender, education, marital status, and work hours. Employees who had more exposure to workplace bullying reported lower levels of quality of life and occupational health. These associations were mediated by work-to-family conflict, such that more exposure to workplace bullying was associated with greater work-to-family conflict, which, in turn, was associated with lower levels of quality of life and occupational health. These mediating pathways were consistent across the three industries. Korean employees who experience more workplace bullying may bring unfinished work stress to the home (thus greater work-to-family conflict), which impairs their well-being. Future research may need to consider the role of work-to-family conflict when targeting to reduce the negative consequences of workplace bullying. Full article
(This article belongs to the Special Issue Using Total Worker Health® to Advance Worker Health and Safety)
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Review

Jump to: Research

19 pages, 1593 KiB  
Review
Total Worker Health® 2014–2018: The Novel Approach to Worker Safety, Health, and Well-Being Evolves
by Sara L. Tamers, L. Casey Chosewood, Adele Childress, Heidi Hudson, Jeannie Nigam and Chia-Chia Chang
Int. J. Environ. Res. Public Health 2019, 16(3), 321; https://doi.org/10.3390/ijerph16030321 - 24 Jan 2019
Cited by 79 | Viewed by 10390
Abstract
Background: The objective of this article is to provide an overview of and update on the Office for Total Worker Health® (TWH) program of the Centers for Disease Control and Prevention’s National Institute for Occupational Safety and Health (CDC/NIOSH). Methods: [...] Read more.
Background: The objective of this article is to provide an overview of and update on the Office for Total Worker Health® (TWH) program of the Centers for Disease Control and Prevention’s National Institute for Occupational Safety and Health (CDC/NIOSH). Methods: This article describes the evolution of the TWH program from 2014 to 2018 and future steps and directions. Results: The TWH framework is defined as policies, programs, and practices that integrate protection from work-related safety and health hazards with promotion of injury and illness prevention efforts to advance worker well-being. Conclusions: The CDC/NIOSH TWH program continues to evolve in order to respond to demands for research, practice, policy, and capacity building information and solutions to the safety, health, and well-being challenges that workers and their employers face. Full article
(This article belongs to the Special Issue Using Total Worker Health® to Advance Worker Health and Safety)
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