Workplace as Community: Influence of Working Conditions on Health Behaviors

Plenary presentation about the influence of working conditions on health behaviors research done by The Center for the Promotion of Health in the New England Workplace (CPH-NEW), a National Institute for Occupational Safety and Health (NIOSH) Center for Excellence. Working conditions link to health outcomes directly, and through health behaviors. The Center evaluates multiple models for integrating health promotion with occupational health interventions, with a strong emphasis on musculoskeletal, cardiovascular, and mental health outcomes; the underlying role of work organization; and the importance of worker involvement in program design and implementation

Estimated and self-reported workloads and lower extremity symptoms for nurses and nursing assistants

Objectives and Significance: In US nursing homes, nursing assistants (NAs) are responsible for direct care and resident handling, while nurses’ roles consist primarily of medication distribution and administrative duties. This study examines differences in observed physical exposures and self-reported knee and ankle symptoms of nurses and NAs. Methods: Observations of clinical staff’s postures and handling were made at fixed time intervals using the PATH Method. An additive physical workload index (PWI) was computed to compare LE workload of NAs and nurses. The PWI combined observed frequencies of postures and handling with their associated forces on the knee and ankle derived from the University of Michigan’s 3D Static Strength Prediction Program. Additionally, surveys on health and working conditions were distributed to employees at 24 nursing homes. Knee and ankle symptoms in the past three months and physical demands were examined by clinical job. Results: Frequencies of postures and handling input into the PWI were based on observations of 275 NAs and 40 nurses. The analysis of PWI for the LE demonstrated higher physical exposures on both the knee and ankle for NAs compared to nurses, especially while NAs were performing resident handling. Among survey participants (n = 1467), NAs reported higher mean physical exertion scores than nurses and also higher frequencies of knee and ankle symptoms (p=0.0076) in the previous three months. Conclusions: In this study, both estimated and self-reported physical workloads were higher among NAs compared to nurses. LE symptoms were also more common among NAs. Safe handling equipment helps reduce some LE exposures for NAs, but interventions for other strenuous tasks should be considered to reduce LE pain symptoms, such as introducing lighter food carts often pushed by NAs and limiting the number of dirty linens bagged before transporting to the soiled linen drop-off

Workplace Predictors of Perceived Quality of Care in Nursing homes

Nursing home quality of care (QOC) is a matter of public concern and public policy. Higher nurse-to-patient ratios have been shown to decrease rates of adverse outcomes. Positive nurse-doctor relationships also have a positive effect, which might translate to other clinical staff, such as nursing aides, who perform the majority of direct care tasks in nursing homes. This cross-sectional study examined whether workplace factors in nursing homes were associated with QOC as evaluated by staff members themselves. Surveys were distributed to personnel in 24 nursing home facilities in the Northeast U.S. A total of 1463 respondents provided ratings of QOC and 14 work environment features. Analyses included correlations, Cronbach’s alpha, and principal components analyses (with rotation) to examine psychometric properties of predictor scales and reduce multicollinearity. A multivariable model of QOC was built using all potential workplace factors to determine which factors contribute to self-reported QOC, with removal of those covariates that were not significant (p\u3e0.05), decreased the model fit, or showed a confounding effect (\u3e15% change in other coefficients). The final model showed that perceived commitment and obstacles to safe-lifting programs, respect and support between coworkers and supervisors, adequacy of staffing, physical exertion, safety climate, and psychological demand, were significant contributors to staff-assessed QOC. Nursing homes should consider cultivating these work environment characteristics for the benefit of both direct-care staff and the residents for whom they provide care

Participating Organizations in Massachusetts Working on Wellness (WoW): Who Are They? What Wellness Programs Have They Put in Place?

Introduction: Most worksite wellness programs are offered by larger employers and accessed by healthier, more educated workers. Massachusetts WoW program is specifically designed to provide guidance in developing wellness programs, with a focus on smaller employers. We examined characteristics of participating organizations and their wellness policies/activity to evaluate the program outreach and delivery. Methods: Organizational and workforce characteristics were collected through an enrollment application. An \u27environmental scan\u27 characterized baseline health-related policies and programs. Wellness intervention activities planned by employers were also collected. Results: The 205 participating organizations are predominantly non-profit (61%) and highly represented by the healthcare and social assistance sector (33%). As a priority of WoW, about one-half of participating organizations have 200 or fewer employees and two-thirds have low-wage workers. At baseline, about half of participating organizations offered no formal wellness program and few policy/environmental supports to encourage wellness activities. The pooled workforce is 63% women, 61% non-Hispanic Whites, and 60% hourly wage workers. About one-quarter have only a high school education/ GED or less, and 17% work evening, night or rotating shifts. WoW has assisted employers to establish program goals, which were predominantly to improve nutrition, increase leisure-time physical activity, and reduce stress. Discussion and Conclusions: The WoW program has successfully reached and delivered services to organizations that previously had no formal wellness program and few wellness policies or supportive environments. In particular, this program has reached a large number of small and moderate-size employer organizations, and a substantial number of low-wage, non-college-educated, and racial/ethnic minority workers

Agreement between a self-administered questionnaire on musculoskeletal disorders of the neck-shoulder region and a physical examination

<p>Abstract</p> <p>Background</p> <p>In epidemiological studies on neck-shoulder disorders, physical examination by health professionals, although more expensive, is usually considered a better method of data collection than self-administered questionnaires on symptoms. However, little is known on the comparison of these two methods of data collection. The agreement between self-administered questionnaires and the physical examination on the presence of neck-shoulders disorders was assessed in the present study.</p> <p>Methods</p> <p>This study was conducted among clerical workers using video display units. Prevalent cases were workers for whom neck-shoulder symptoms were present for at least 3 days during the previous 7 days and for whom pain intensity was greater than 50 mm on a 100 mm visual analogue scale. All 85 workers meeting this definition and a random sample of 102 workers who did not meet this definition were selected. Physical examination included measures of active range of motion and musculoskeletal strength. Cohen's kappa and global percent agreement were calculated to compare the two methods of data collection. The effect on the agreement of different question and physical examination definitions and the importance of the time interval elapsed between the administrations of the tests were also evaluated.</p> <p>Results</p> <p>Kappa coefficients ranged from 0.19 to 0.54 depending on the definitions used to ascertain disorders. The agreement was highest when the two instruments were administered 21 days apart or less (Kappa = 0.54, global agreement = 77%). It was not substantially improved by the addition of criteria related to functional limitations or when comparisons were made with alternative physical examination definitions. Pain intensity recorded during physical examination maneuvers was an important element of the agreement between questionnaire and physical examination findings.</p> <p>Conclusion</p> <p>These results suggest a fair to good agreement between the presence of musculoskeletal disorders ascertained by self-administered questionnaire and physical examination that may reflect differences in the constructs measured. Shorter time lags result in better agreement. Investigators should consider these results before choosing a method to measure the presence of musculoskeletal disorders in the neck-shoulder region.</p

Working on Wellness: A Capacity Building Program for Massachusetts Employers

In recent years, more worksites have shown an interest in offering wellness programs to their employees. However, uptake of worksite wellness programs remains low among certain employer groups, such as small businesses and employers in low wage industries. This poster will highlight the Working on Wellness (WoW) program; an innovative \u27capacity building\u27 program designed to help employers across the state implement evidence-based worksite initiatives and policies that foster a healthier work environment. Through a collaborative partnership with the MA Department of Public Health, a public health institute, a cadre of worksite wellness experts, and university researchers, over 150 businesses were recruited to participate in WoW this past year. This poster will describe WoW\u27s innovative framework, the tools and resources available to businesses (e.g., seed funding, community connections and collaboration, access to a comprehensive online curriculum, and technical assistance), and examine program strengths and weaknesses. The methods used in this model to teach the concepts and skills of building a worksite wellness program will be examined. The evaluation aspects of the program, undertaken by UMass Medical and UMass Lowell will be identified. Lastly, the poster will feature case studies of participating organizations, highlighting the interventions implemented in their worksites to impact employee health. This poster is one of a series of posters on this project presented by the project team: UMass Medical, UMass Lowell, Health Resources in Action and AdvancingWellness

Working on Wellness: Building Capacity through Community Partnerships

Establishing a wellness initiative in the workplace is a popular way for employers to attract and retain top talent, reduce health costs, and increase productivity. However, building a comprehensive wellness initiative can put a strain on an organization\u27s time and resources. Working on Wellness (WoW) is an innovative \u27capacity building\u27 program designed to help employers across Massachusetts implement evidence-based worksite initiatives and policies that foster a healthier work environment. To broaden the understanding among employers about what influences health, WoW\u27s Community Partnerships component introduces organizations to the notion that businesses can play a key role in building healthy communities. The curriculum describes how employers can join efforts to improve the places where they live, work and play. Businesses are encouraged to incorporate interventions into their worksite wellness programs and policies that show mutually beneficial outcomes between employers and community partners. This poster will introduce tools and resources created through WoW including our approach to introduce community partnerships through our online training modules and our Community Scan assessment tool, which provides a roadmap to consider traditional and nontraditional partners for organization\u27s wellness interventions. The poster will feature case studies highlighting how participants used the Community Scan to find and establish strong partnerships to reach their goals of increasing fruit and vegetable consumption, reducing stress, and increasing physical activity among employees and community residents. This poster is one of a series of posters on this project presented by the project team: UMass Medical, UMass Lowell, Health Resources in Action and AdvancingWellness