Factors influencing the development, recruitment, integration, retention and career development of advanced practice providers in hospital health care teams: a scoping review.

BACKGROUND: Advanced practice providers (APPs), including physician assistants/associates (PAs), nurse practitioners (NPs) and other non-physician roles, have been developed largely to meet changing healthcare demand and increasing workforce shortages. First introduced in primary care in the US, APPs are prevalent in secondary care across different specialty areas in different countries around the world. In this scoping review, we aimed to summarise the factors influencing the development, recruitment, integration, retention and career development of APP roles in hospital health care teams. METHODS: We conducted a scoping review and searched Ovid MEDLINE, Ovid Embase, Ovid Global Health, Ovid PsycINFO and EBSCOhost CINAHL to obtain relevant articles published between Jan 2000 and Apr 2023 that focused on workforce management of APP roles in secondary care. Articles were screened by two reviewers independently. Data from included articles were charted and coded iteratively to summarise factors influencing APP development, recruitment, integration, retention and career development across different health system structural levels (macro-, meso- and micro-level). RESULTS: We identified and analysed 273 articles that originated mostly from high-income countries, e.g. the US (n = 115) and the UK (n = 52), and primarily focused on NP (n = 183) and PA (n = 41). At the macro-level, broader workforce supply, national/regional workforce policies such as work-hour restrictions on physicians, APP scope of practice regulations, and views of external collaborators, stakeholders and public representation of APPs influenced organisations' decisions on developing and managing APP roles. At the meso-level, organisational and departmental characteristics, organisational planning, strategy and policy, availability of resources, local experiences and evidence as well as views and perceptions of local organisational leaders, champions and other departments influenced all stages of APP role management. Lastly at the micro-level, individual APPs' backgrounds and characteristics, clinical team members' perceptions, understanding and relationship with APP roles, and patient perceptions and preferences also influenced how APPs are developed, integrated and retained. CONCLUSIONS: We summarised a wide range of factors influencing APP role development and management in secondary care teams. We highlighted the importance for organisations to develop context-specific workforce solutions and strategies with long-term investment, significant resource input and transparent processes to tackle evolving healthcare challenges.

Addition of a Novel Qualitative Technique to Standard Quantitative Practices for Evaluation of Hazardous Drug Exposure in a Canadian Hospital Setting.

Background: Current recommendations from regulatory authorities suggest quantitative surface sampling for detection of hazardous drugs at least once every 6 months. A more frequent and efficient process for hazardous drug testing might reduce the safety risks associated with exposure to these agents. Objectives: The primary objective was to assess the findings of surface testing based on traditional quantitative sampling methods relative to the findings of qualitative surface sample testing with the BD HD Check system. The secondary objectives included assessment of the ease of integrating qualitative sampling into pharmacy protocols and identification of opportunities to enhance patient and staff education and safety. Methods: Samples from 23 unique surfaces were tested concurrently once a month for 5 months using a quantitative surface sampling method and the qualitative BD HD Check system on adjacent 12 inch × 12 inch (30.5 cm × 30.5 cm) surface areas. The presence or absence of cyclophosphamide, methotrexate, and/or doxorubicin contamination was assessed by each of the 2 testing methods. The BD HD Check system was also assessed for ease of use and efficiency. Results: Ten areas of contamination were identified over the 5-month period. Nine were detected by the BD HD Check system and one by the quantitative system. The BD HD Check system was easy to use, with results available in less than 10 minutes per area tested. Conclusions: The BD HD Check system allows for more timely identification of surface contamination with hazardous drugs than the standard sampling protocol. The discrepancy in results between the 2 methods of hazardous drug surface sampling requires further investigation.

Contexte: Les recommandations actuelles des autorités de réglementation suggèrent de procéder à un échantillonnage de surface quantitatif pour la détection de médicaments dangereux au moins une fois tous les 6 mois. Un processus de test des médicaments dangereux plus fréquent et plus efficace pourrait réduire les risques de sécurité associés à l'exposition à ces agents. Objectifs: L'objectif principal visait à évaluer les résultats de l'échantillonnage de surface basé sur les méthodes d'échantillonnage quantitatives traditionnelles par rapport aux résultats des tests qualitatifs d'échantillons de surface effectués avec le système de détection des médicaments dangereux BD HD Check. Les objectifs secondaires comprenaient l'évaluation de la facilité d'intégration de l'échantillonnage qualitatif dans les protocoles pharmaceutiques et l'identification des occasions d'améliorer l'éducation et la sécurité des patients et du personnel. Méthodologie: Des échantillons provenant de 23 surfaces uniques ont été testés simultanément une fois par mois pendant 5 mois à l'aide d'une méthode d'échantillonnage de surface quantitative et du système BD HD Check sur des surfaces adjacentes de 12 pouces × 12 pouces (30,5 cm × 30,5 cm). La présence ou l'absence de contamination par le cyclophosphamide, le méthotrexate et/ou la doxorubicine a été évaluée à l'aide de chacune des 2 méthodes de test. La facilité d'utilisation et l'efficacité du système BD HD Check ont également fait l'objet d'une évaluation. Résultats: Dix zones de contamination ont été identifiées sur la période de 5 mois. Neuf ont été détectées par le système BD HD Check et une par le système quantitatif. Le système BD HD Check était facile à utiliser et les résultats étaient prêts en moins de 10 minutes par zone testée. Conclusions: Le système BD HD Check permet d'identifier plus rapidement la contamination de surface par médicaments dangereux que le protocole d'échantillonnage standard. L'écart dans les résultats entre les 2 méthodes d'échantillonnage de surface des médicaments dangereux nécessite une étude plus approfondie.

Cultural blind spots: Identifying hidden psychosocial hazards in the workplace.

ISSUE ADDRESSED: This article presents a framework to identify hidden psychosocial hazards and emerging mental health risks in the workplace, thereby assisting Persons Conducting a Business or Undertaking. The framework adds value to the processes outlined in SafeWork NSW's Code of Practice for Managing Psychosocial Hazards At Work. Specifically, the article documents a framework to analyse microcultures and back stage sites of enactment where psychosocial hazards and risks may be hidden or obscured in workplace settings. BACKGROUND: The article's framework aims to bring to the surface both the intra and interpersonal tensions employees experience in the social reality they inhabit while they perform their work, thereby positively contributing to organisations and PCBUs by helping them create healthy workplace cultures and psychological safety. METHODS: Specifically, the article discusses partnering with an organisational ethnographer when a PCBU embarks upon psychosocial investigations to: gain access, select employee participants, start conversations, establish rapport, build trust, collect and analyse data. CONCLUSION: This article theoretically contributes to health promotion literatures by offering organisations a complementary way of extracting deeper insights and understandings of psychosocial hazards and emerging mental health risks which are not apparent with traditional methods of inquiry.

Why do Stayers Stay? Perceptions of White and Black Long-Term Employees in a Community Mental Health Center.

Previous research has focused on factors influencing turnover of employees in the mental health workforce, yet little research has explored reasons why employees stay. To facilitate retaining a diverse mental health workforce, the current study aimed to elucidate factors that contributed to employees' tenure at a community mental health center (CHMC) as well as compare these perceptions between Black and White employees. Long-term employees (7 years or more) from one urban CMHC (n = 22) completed semi-structured stayer interviews. Using emergent thematic analysis, stayer interviews revealed four major themes for why they have stayed at the organization for 7 years or more: (1) work as a calling, (2) supportive relationships, (3) opportunities for growth or meaningful contribution, and (4) organization mission's alignment with personal attributes or values. Comparison between Black and White stayer narratives revealed differences in their perceptions with work as a calling and opportunities for growth and meaningful contribution. Guided by themes derived from stayer interviews, the current study discusses theoretical (e.g., job embeddedness theory, theory of racialized organizations, self-determination theory) and practical implications (e.g., supporting job autonomy, Black voices in leadership) in an effort to improve employee retention and address structural racism within a mental health organization.

The inverted-U model of employee happiness: examining overdose happiness in context of personal characteristics, job-relationship dependency, benign stress, and various theories.

In recent years, the management literature has begun to deal with individual and organizational results after happiness rather than the pursuit of happiness in business life and finally reaching happiness. After the fact that everything in an overdose is harmful, it has become the subject of even more research with paradoxical results that happiness that evokes positive emotions is not as innocent as it seems. In this study, which aims to reveal the harmful effects of overdose of employee happiness, the reasons for the manager's fear - or anxiety - about the happiness of his employees are interpreted. The Inverted-U Model of Employee Happiness (IUMEH) has been developed and individual work outputs have been evaluated in three areas that (1) support happiness, (2) reflect balanced happiness, and (3) turn negative with an overdose of happiness intoxication. It has been suggested that IUMEH, which is thought to contribute to the literature as it is the first descriptive model to emerge, should be supported by applied studies, and it has been reminded that the curvilinear aspect of the model may include differences in terms of culture, type and characteristics of job, private, public or non-profit enterprises, generations of managers and the level of managers (front-line, middle level and senior level etc.).

Integrating the ESM usage and work engagement for employee agility performance: based on regulatory focus theory.

This present research aims to clarify the intricate conjunction of enterprise social media (ESM) utilization and employee agility with a main focus on uncovering the underlying mechanisms that work through the mediating influence of work engagement and the moderating influence of regulatory focus. Drawing upon regularity focus theory, 353 Chinese samples of ESM users in organizational contexts are analyzed using SPSS 23.0. The empirical findings substantiate a robust and significant positive linkage between ESM usage and worker agility. Further reinforcing the model, the mediating role of work engagement is established as it channels the impact of ESM usage on worker agility. Turning to the moderating effects, the study unveils the differential impact of prevention focus and promotion focus, wherein individuals with a lower prevention focus exhibit a more pronounced positive linkage between ESM usage and worker agility. Similarly, individuals with a higher promotion focus demonstrate a heightened positive association between ESM usage and worker agility. By comprehensively inspecting the intricate dynamics of ESM usage, work engagement, and regulatory focus, this study enhances our theoretical understanding of how these factors synergistically shape employee agility, ultimately furnishing organizations with invaluable insights to foster and cultivate an agile workforce.

Work-life balance and employee commitment: mediating effect of job satisfaction.

Introduction: Work is very important to man and work experiences have implications on other aspects of human life. The major essence of work is to obtain resources to optimize other domains of life. This demands the need to strike a balance. Flowing from the positive and negative effect of the Spill over theory, the study investigated the influence of work-life balance (WLB) on employee job commitment using JS as the mediating variable. Methods: A cross-sectional survey design elicited the desired data from 344 employees in 4 Universities and 4 multinational companies. Path diagram analysis served as the data analysis technique. Results/discussion: The results show that all the family and religious lives have statistically significant negative influences on employee commitment (EMPC) while leisure and health have statistically significant positive influences on EMPC. The study thus, makes theoretical contributions.

Double-Duty Carers' Health and Wellbeing during COVID-19: Exploring the Role of Mobility of the Care Economy in Southern Ontario, Canada.

Double-Duty Carers (DDCs) refer to people who work in the healthcare industry while also providing unpaid care to relatives, friends, or neighbours. The expectations placed on DDCs is expected to grow, and these employees already experience a high caring burden. As such it is important to understand how best to support their health and wellbeing. This paper explores DDCs' wellbeing during the COVID-19 pandemic, focusing an understudied factor: their mobility constraints. Following the Mobility of the Care Economy framework and a qualitative research design, it does so through a thematic analysis of 16 semi-structured interviews with female DDCs in Southern Ontario, Canada. Once data saturation was reached, three mobility pathways during the pandemic were identified, all of which negatively affected DDCs wellbeing. First, some COVID-19 policies (e.g., testing requirements) resulted in increased mobility demands and increased spatiotemporal constraints. Second, the closure of institutions that care for dependents (schools, daycares, day centres) resulted in forced reduced mobility, which increased financial stress. Finally, indirect mobility effects were identified: the reduced mobility of other informal carers increased the workload and emotional strain on DDCs. The paper concludes with a discussion of mobility-related policies that could improve DDC wellbeing.

Improvement and Maintenance of Clinical Outcomes in a Digital Mental Health Platform: Findings From a Longitudinal Observational Real-World Study.

BACKGROUND: Digital mental health services are increasingly being provided by employers as health benefit programs that can improve access to and remove barriers to mental health care. Stratified care models, in particular, offer personalized care recommendations that can offer clinically effective interventions while conserving resources. Nonetheless, clinical evaluation is needed to understand their benefits for mental health and their use in a real-world setting. OBJECTIVE: This study aimed to examine the changes in clinical outcomes (ie, depressive and anxiety symptoms and well-being) and to evaluate the use of stratified blended care among members of an employer-sponsored digital mental health benefit. METHODS: In a large prospective observational study, we examined the changes in depressive symptoms (9-item Patient Health Questionnaire), anxiety symptoms (7-item Generalized Anxiety Disorder scale), and well-being (5-item World Health Organization Well-Being Index) for 3 months in 509 participants (mean age 33.9, SD 8.7 years; women: n=312, 61.3%; men: n=175, 34.4%; nonbinary: n=22, 4.3%) who were newly enrolled and engaged in care with an employer-sponsored digital mental health platform (Modern Health Inc). We also investigated the extent to which participants followed the recommendations provided to them through a stratified blended care model. RESULTS: Participants with elevated baseline symptoms of depression and anxiety exhibited significant symptom improvements, with a 37% score improvement in depression and a 29% score improvement in anxiety (P values <.001). Participants with baseline scores indicative of poorer well-being also improved over the study period (90% score improvement; P=.002). Furthermore, over half exhibited clinical improvement or recovery for depressive symptoms (n=122, 65.2%), anxiety symptoms (n=127, 59.1%), and low well-being (n=82, 64.6%). Among participants with mild or no baseline symptoms, we found high rates of maintenance for low depressive (n=297, 92.2%) and anxiety (n=255, 86.7%) symptoms and high well-being (n=344, 90.1%). In total, two-thirds of the participants (n=343, 67.4%) used their recommended care, 16.9% (n=86) intensified their care beyond their initial recommendation, and 15.7% (n=80) of participants underused care by not engaging with the highest level of care recommended to them. CONCLUSIONS: Participants with elevated baseline depressive or anxiety symptoms improved their mental health significantly from baseline to follow-up, and most participants without symptoms or with mild symptoms at baseline maintained their mental health over time. In addition, engagement patterns indicate that the stratified blended care model was efficient in matching individuals with the most effective and least costly care while also allowing them to self-determine their care and use combinations of services that best fit their needs. Overall, the results of this study support the clinical effectiveness of the platform for improving and preserving mental health and support the utility and effectiveness of stratified blended care models to improve access to and use of digitally delivered mental health services.

Development of an Artificial Intelligence-Based Tailored Mobile Intervention for Nurse Burnout: Single-Arm Trial.

BACKGROUND: Nurse burnout leads to an increase in turnover, which is a serious problem in the health care system. Although there is ample evidence of nurse burnout, interventions developed in previous studies were general and did not consider specific burnout dimensions and individual characteristics. OBJECTIVE: The objectives of this study were to develop and optimize the first tailored mobile intervention for nurse burnout, which recommends programs based on artificial intelligence (AI) algorithms, and to test its usability, effectiveness, and satisfaction. METHODS: In this study, an AI-based mobile intervention, Nurse Healing Space, was developed to provide tailored programs for nurse burnout. The 4-week program included mindfulness meditation, laughter therapy, storytelling, reflective writing, and acceptance and commitment therapy. The AI algorithm recommended one of these programs to participants by calculating similarity through a pretest consisting of participants' demographics, research variables, and burnout dimension scores measured with the Copenhagen Burnout Inventory. After completing a 4-week program, burnout, job stress, stress response using the Stress Response Inventory Modified Form, the usability of the app, coping strategy by the coping strategy indicator, and program satisfaction (1: very dissatisfied; 5: very satisfied) were measured. The AI recognized the recommended program as effective if the user's burnout score reduced after the 2-week program and updated the algorithm accordingly. After a pilot test (n=10), AI optimization was performed (n=300). A paired 2-tailed t test, ANOVA, and the Spearman correlation were used to test the effect of the intervention and algorithm optimization. RESULTS: Nurse Healing Space was implemented as a mobile app equipped with a system that recommended 1 program out of 4 based on similarity between users through AI. The AI algorithm worked well in matching the program recommended to participants who were most similar using valid data. Users were satisfied with the convenience and visual quality but were dissatisfied with the absence of notifications and inability to customize the program. The overall usability score of the app was 3.4 out of 5 points. Nurses' burnout scores decreased significantly after the completion of the first 2-week program (t=7.012; P<.001) and reduced further after the second 2-week program (t=2.811; P=.01). After completing the Nurse Healing Space program, job stress (t=6.765; P<.001) and stress responses (t=5.864; P<.001) decreased significantly. During the second 2-week program, the burnout level reduced in the order of participation (r=-0.138; P=.04). User satisfaction increased for both the first (F=3.493; P=.03) and second programs (F=3.911; P=.02). CONCLUSIONS: This program effectively reduced burnout, job stress, and stress responses. Nurse managers were able to prevent nurses from resigning and maintain the quality of medical services using this AI-based program to provide tailored interventions for nurse burnout. Thus, this app could improve qualitative health care, increase employee satisfaction, reduce costs, and ultimately improve the efficiency of the health care system.

Single-Facility Analysis of COVID-19 Status of Healthcare Employees during the Eighth and Ninth Pandemic Waves in Japan after Introducing Regular Rapid Antigen Testing.

BACKGROUND: Community infections of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have increased rapidly since the emergence of the Omicron strain. During the eighth and ninth pandemic waves-when movement restrictions in the community were eased-the all-case registration system was changed, and the actual status of infection became uncertain. METHODS: We conducted regular rapid antigen tests (R-RATs) once or twice a week as self-testing to examine the actual state of coronavirus disease (COVID-19) diagnosis among healthcare employees. RESULTS: Overall, 320 (1.42/day) and 299 (1.76/day) employees were infected in the eighth and ninth pandemic waves. During both periods, 59/263 doctors (22.4%), 335/806 nurses (41.6%), 92/194 administrative employees (47.4%), and 129/218 clinical laboratory technicians (59.2%) were infected. In the eighth wave, 56 of 195 employees were infected through close contact; in the ninth wave, 26 of 62 employees were infected. No significant difference was observed in the number of vaccinations between infected and non-infected employees. The positivity rate of R-RATs was 0.41% and 0.45% in the eighth and ninth waves. R-RATs detected infection in 212 and 229 employees during the eighth and ninth waves, respectively; the ratio of R-RAT-detected positive employees to those who reported infection was significantly higher during the ninth wave (odds ratio: 1.67, 95% confidence interval: 1.17-2.37, p < 0.001). CONCLUSIONS: The number of infected healthcare employees remained high during the eighth and ninth pandemic waves in Japan. The R-RAT is considered effective for detecting mild or asymptomatic COVID-19 at an early stage and at a high rate in healthcare employees.

Countering technostress in virtual work environments: The role of work-based learning and digital leadership in enhancing employee well-being.

Virtual work has been highlighted as an important business trend nowadays. Technostress caused by information and communication technology threatens employee well-being in a virtual context. We integrate insights from the Job Demands-Resources theory to explore the impact of technostress on employee well-being and examine work-based learning and digital leadership capability as buffers of this negative impact via the attenuating effect of work exhaustion. We collected multi-wave survey data from 300 virtual employees to test the theoretical model. Results revealed a significant negative impact of technostress on employee well-being. However, work-based learning and digital leadership capability buffered employees' well-being from this negative effect by reducing their work exhaustion. Our findings extend our understanding of work design and shed light on how to cope with virtual work demands.

Mitigating Job Burnout in Jordanian Public Healthcare: The Interplay between Ethical Leadership, Organizational Climate, and Role Overload.

In today's dynamic organizational landscape, characterized by rapid technological advancements and evolving workplace dynamics, understanding the factors influencing employee well-being is paramount. This study investigates the interplay between ethical leadership, organizational climate, role overload, and job burnout in public healthcare organizations across northern Jordan. By focusing on ethical leadership, organizational climate, and role overload as determinants of job burnout, this research provides insights into strategies for enhancing employee well-being. Drawing on ethical leadership theory, social exchange theory, and the job demands-resources model, this study employs PLS-SEM to analyze data collected from 260 employees working in Jordanian government hospitals. The findings reveal negative associations between ethical leadership and job burnout, highlighting the importance of ethical leadership behaviors in mitigating employee burnout. Additionally, a positive organizational climate is associated with lower levels of burnout, underscoring the impact of the broader organizational context on employee well-being. The study also explores the mediating role of organizational climate and the moderating effect of role overload in the relationship between ethical leadership and job burnout, providing insights into the complex dynamics at play in healthcare organizations. These findings enrich our understanding of the factors influencing employee well-being in healthcare contexts and underscore the importance of fostering ethical leadership and supportive organizational climates to mitigate job burnout.

Misaligned Supports: Differences in Reported Health Care Worker Well-being Supports Provided and Needed During the COVID-19 Pandemic.

PURPOSE: To describe the well-being supports provided to health care workers (HCWs) during the COVID-19 pandemic in health centers and hospitals. DESIGN: Cross-sectional qualitative interviews before and after implementation of a peer-based support intervention. SETTING: Purposively sampled hospitals and health centers across the US. PARTICIPANTS: 28 site leaders and 56 HCWs sampled from 16 hospitals and 12 health centers. METHOD: Site leaders and HCWs were asked to describe supports available to HCWs during the COVID-19 pandemic. Thematic and content coding and analysis of interview responses were conducted using Dedoose. RESULTS: Both site leaders and HCWs identified a range of support resources available. Communication resources were the most frequently cited in both groups. Health care workers reported bi-directional communication, while one-way communication was emphasized by site leaders. Hospitals highlighted counseling support, particularly Employee Assistance Programs (EAP), while health centers prioritized community support. Wellness activities were more prevalent in hospital settings, while health centers offered specific workplace-provided training for HCWs. Health care workers encountered barriers when accessing support, including limited time, fear of stigma, and disruptions to their existing support networks attributable to the pandemic. CONCLUSION: While there are resources for HCWs, the available supports may not align with their needs and barriers to access may limit the effectiveness of these supports. Continued engagement between leaders and HCWs could help better align resources with needs.

The Impact of Exercise and Health Management on Workplace Creativity.

Objectives: This study aimed to investigate Japan's service sector employees to determine whether employee creativity is associated with the provision of a fitness program (that encourages employees to perform physical exercise) or a health and productivity management (H&PM) program at the workplace. Design: This was a cross-sectional study. Methods: A nationwide online survey was conducted using stratified sampling. Data were obtained for respondents' demographic characteristics, subjective health, exercise frequency, and organizational wellness support. Workplace creativity, psychological safety, and leadership were evaluated using standardized scales. A binary logistic regression was performed to examine the relationship between organizational wellness support programs and workplace creativity. Results: Respondents were 1,955 full-time employees in private-sector organizations (979 men and 976 women; mean age 40.30 ± 10.85). Workplace creativity was significantly more likely respondents whose employers provided a fitness program (adjusted OR = 1.86, 95% CI = 1.39-2.48, p<.001) or an H&PM program (adjusted OR = 2.07, 95% CI = 1.53-2.80, p<.001). Furthermore, workplace creativity was significantly more likely in employees who perceived themselves as rather healthy or healthy. Employees who exercised frequently over the past year were more likely to display creativity than those never exercised. Conclusions: Workplace creativity was associated with good subjective health, high exercise frequency, and organizational wellness support programs offered by employers. Human resource management for employees' fitness and health is crucial for cultivating the productivity and innovation necessary for business success.

Exploring the Theory of Employee Planned Behavior: Job Satisfaction as a Key to Organizational Performance.

This article introduces a significant advancement with the "Theory of Employee Planned Behavior" (TEPB), a novel extension of the well-established Theory of Planned Behavior (TPB). The TEPB uniquely positions job satisfaction as a central determinant in driving organizational performance. Using data from county-level government institutions in the United States, this research offers a nuanced exploration into how employee satisfaction influences organizational commitment and citizenship behaviors, which, in turn, substantially impact organizational performance. Our approach utilizes a significant dataset involving 372 dyads across hierarchical levels in government institutions. Through the application of Structural Equation Modeling (SEM), we rigorously validate the TEPB model. The results highlight a significant relationship where enhanced job satisfaction leads to stronger organizational commitment. This heightened commitment further fosters organizational citizenship behaviors, crucial in achieving superior organizational performance. This work notably extends the TPB model by integrating organizational performance as a consequential outcome. It also provides empirical evidence of the direct relationship between job satisfaction and organizational performance, specifically in the context of government institutions. Such findings are invaluable for organizational executives and policymakers in recognizing the paramount importance of employee satisfaction for organizational success. Overall, the TEPB model presented in this study offers a holistic and practical framework for organizations seeking to understand and effectively manage employee behavior. By focusing on job satisfaction, organizations can foster a more committed and proactive workforce, significantly improving performance and efficiency.

A population health approach to workplace mental health: rationale, implementation and engagement.

Objectives: To describe a population health-based program to support employee and dependent mental health and learn from engagement trends. Methods: Retrospective analysis of a program utilizing an assessment of mental health risk. For scoring "at risk," a Care Concierge is offered to connect users with resources. Results: Participation was offered to 56,442 employees and dependents. Eight thousand seven hundred thirty-one completed the assessment (15%). Of those, 4,644 (53%) scored moderate or higher. A total of 418 (9%) engaged the Care Concierge. Factors that negatively influenced the decision to engage care included bodily pain, financial concerns. Positive influences were younger age, high stress, anxiety, PTSD and low social support. Conclusion: Proactive assessment plus access to a Care Concierge facilitates mental healthcare utilization. Several factors influence likelihood to engage in care. A better understanding of these factors may allow for more targeted outreach and improved engagement.

The study of constructing evaluation indicators for the implementation of employee assistance programs in public sectors.

Introduction: Employee assistance programs require resources and manpower of various natures across different types of public sector organization. Methods: This study began by outlining elements for comparing employee assistance programs' evaluation criteria in four types of public sector organization on the basis of 22 service measures for such programs implemented by the Ministry of Labor in relation to three major aspects: work, life, and health. Elements of the evaluation criteria for public sector employee assistance programs were determined by surveying a panel of experts using the modified Delphi method. Last, the weight associated with the elements of evaluation criteria were calculated using the fuzzy analytic hierarchy process, and the criteria of four types of public sector organization were explored. Results: Data analysis indicated that the weight and priorities associated with elements of evaluation criteria for EAPs implemented by four types of public sector organization were not fully identical. Discussion: The results of this study suggest that, in terms of EAPs, the Directorate-General of Personnel Administration of the Executive Yuan should be pursuant to appropriate employee assistance programs provided by various public sector organizations according to the needs of their employees as well as the diverse objective conditions in which these organizations operate.

Psychology and the lie detector industry: A fifty-year perspective.

Fifty years ago, in a trenchant analysis that challenged applied lie detection theory and science, David Lykken (1974) brought polygraphic interrogation methods to the attention of academia with the hope that these techniques would come under the purview of psychology and psychophysiology. In this perspective, I examine how this application of psychophysiology has evolved over the last half century and how its status has changed for 1) the comparison (control) question test (CQT), used in forensic applications; 2) polygraph screening tests, used to evaluate examinee integrity; and 3) the concealed information technique (CIT), used to assess recognition memory of crime details. The criticisms of the CQT and screening tests advanced by Lykken have been amplified and focused by the academic community over the last half century. However, this has had little effect on how these methods are practiced and has not curtailed their use. Although most private sector employee screening tests are now prohibited, personnel screening of government employees has increased, and screening tests of sex offenders are now commonplace. Even though the CIT has captured the interest of psychophysiologists as a scientifically defensible technique, its field use is negligible. A primary purpose of polygraphic interrogations continues to be the extraction of admissions and confessions. The lack of change in the polygraph testing status quo stems in large part from unwavering government support for the use of these methods. As a result, polygraph theory and research support continues to rest on shaky ground while practice continues unfettered by valid criticism.