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OBJECTIVE: The cross-sectional study evaluates if the pre-pandemic work environments in nursing homes predict COVID-19 cases among residents and staff, accounting for other factors. METHOD: Leveraging data from a survey of California and Ohio nursing homes (n = 340), we examined if Workplace Integrated Safety and Health domains - Leadership, Participation, and Comprehensive and Collaborative strategies predicted cumulative COVID-19 cases among nursing home residents and staff. RESULTS: In Ohio, a 1-unit increase in Leadership score was associated with 2 fewer staff cases and 4 fewer resident cases. A 1-unit increase in Comprehensive and Collaborative Strategies score in California showed an average marginal effect of approximately 1 less staff case and 2 fewer resident cases. CONCLUSION: These findings suggest that leadership commitment and inter-department collaboration to prioritize worker safety, may have protected against COVID-19 cases in nursing homes.
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BACKGROUND: Few studies have addressed whether using manager or worker perceptions of safety policies and practices alone predict reported injury rates less accurately than using both. OBJECTIVE: This study provides an example and describes a method that can be used to address this issue with survey instruments designed to measure safety climate, policies, or practices. METHODS: Using multilevel logistic regression, we estimated the relationship between worker and manager perceptions of a given exposure and the odds of worker injury during the post-survey year for three safety scales. We tested whether surveying both workers and managers provides additional predictive value compared with surveying just one group. RESULTS: Injury in the year following the survey was significantly associated with worker scores on two of the three scales. Manager responses were not significantly associated with injury and did not significantly improve injury rate prediction when added to a model with only worker survey responses. CONCLUSIONS: The capacity of manager-only or worker-only perceptions of safety policies and practices to predict worker injuries should be established before choosing to survey just one or the other. The approach and findings in this paper can be applied to other survey instruments and in other settings to help make this choice.
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BACKGROUND: Hospital patient-care workers have high occupational injury rates. While physical hazards within hospital work environments are established determinants of injury, social exposures may also contribute. This study examined how reports of unfair treatment at work, a dimension of work-related experiences of discrimination, were associated with injury among hospital-based patient-care workers. METHODS: We used data from the Boston Hospital Workers Health Study, a longitudinal cohort of nurses and nursing assistants at two Boston-area hospitals. In 2018, we conducted a worker survey asking about three types of unfair treatment at work and occupational injuries during the past year. We used mixed-effects logistic regression models to evaluate associations between specific types, total load, and high-frequency exposure of unfair treatment with injury, adjusting for age, gender, race and ethnicity, job title, and unit type. RESULTS: Among 1001 respondents, 21% reported being humiliated in front of others at work, 28% reported being watched more closely than other workers, and 47% reported having to work twice as hard as others for the same treatment. For each type of unfair treatment, we observed a monotonic relationship with occupational injury wherein increasing frequency of exposure was associated with increased odds of injury. We also observed monotonic relationships between total load and high-frequency exposure to unfair treatment and odds of injury. CONCLUSIONS: Work-related unfair treatment is associated with injury among hospital workers. Programs and policies that focus on preventing unfair treatment may lessen injury burden in hospital workers.
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Traumatismos Ocupacionales , Humanos , Masculino , Femenino , Adulto , Traumatismos Ocupacionales/epidemiología , Persona de Mediana Edad , Boston/epidemiología , Estudios Longitudinales , Encuestas y Cuestionarios , Personal de Enfermería en Hospital/estadística & datos numéricos , Personal de Enfermería en Hospital/psicología , Asistentes de Enfermería/estadística & datos numéricos , Prejuicio , Lugar de Trabajo/estadística & datos numéricosRESUMEN
BACKGROUND: Thriving from Work is a construct that has been highlighted as an important integrative positive worker well-being indicator that can be used in both research and practice. Recent public discourse emphasizes the important contributions that work should have on workers' lives in positive and meaningful ways and the importance of valid and reliable instruments to measure worker well-being. The Thriving from Work Questionnaire measures how workers' experiences of their work and conditions of work contributes in positive ways to their thriving both at and outside of work. METHODS: The purpose of this study was to translate the Thriving from Work Questionnaire from English to Spanish, and then validate the translated questionnaire in a sample of 8,795 finance workers in Peru and Mexico. We used item response theory models replicating methods that were used for the original validation studies. We conducted a differential item functioning analysis to evaluate any differences in the performance of models between Peru and Mexico. We evaluated criterion validity with organizational leadership, flourishing, vitality, community well-being, and worker's home location socio-economic position. RESULTS: The current study demonstrates that the Spanish (Peru/Mexico) questionnaire was found to be a reliable and valid measure of workers' thriving from work. One item was dropped from the long-form version of the original U.S. questionnaire. Both the long and short form versions of the questionnaire had similar psychometric properties. Empirical reliability was high. Criterion validity was established as hypothesized relationships between constructs was supported. There were no differences in the performance of the model between countries suggesting utility across Latin American countries. CONCLUSIONS: The current study demonstrated that the Spanish (Peru and Mexico) version of the questionnaire is both a reliable and valid measure of worker well-being in Latin America. Specific recommendations are made for the adaptation of the questionnaire and directions of future research.
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Traducciones , Humanos , Encuestas y Cuestionarios/normas , Masculino , México , Femenino , Adulto , Perú , Persona de Mediana Edad , Reproducibilidad de los Resultados , Satisfacción en el Trabajo , PsicometríaRESUMEN
OBJECTIVES: To assess whether a measure of leadership support for worker safety, health, and well-being predicts staff turnover in nursing homes after controlling for other factors. DESIGN: This paper uses administrative payroll data to measure facility-level turnover and uses a survey measure of nursing home leadership commitment to workers. In addition, we use data from Medicare to measure various nursing home characteristics. SETTING AND PARTICIPANTS: Nursing homes with at least 30 beds serving adults in California, Ohio, and Massachusetts were invited to participate in the survey. The analysis sample included 495 nursing homes. METHODS: We used a multivariable ordinary least squares model with turnover rate as the dependent variable. We used an indicator for nursing homes who scored above the median on the measure of leadership that supports worker safety, health, and well-being. Control variables include bed count (deciles), ownership (corporate/noncorporate × for-profit/not-for-profit), percent of residents on Medicaid, state, being in a nonmetropolitan county, and total nurse staffing per patient day in the 2 quarters before the survey. RESULTS: The unadjusted turnover rate was lower for those nursing homes that scored higher on leadership commitment to worker safety, health, and well-being. After controlling for additional variables, greater leadership commitment was still associated with lower turnover but with some attenuation. CONCLUSIONS AND IMPLICATIONS: We find that nursing homes with leadership that communicated and demonstrated commitment to worker safety, health, and well-being had relatively fewer nurses leave during the study period, with turnover rates approximately 10% lower than homes without. These findings suggest that leadership may be a valuable tool for reducing staff turnover.
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Liderazgo , Medicare , Anciano , Estados Unidos , Adulto , Humanos , Casas de Salud , Instituciones de Cuidados Especializados de Enfermería , MassachusettsRESUMEN
This Viewpoint examines some of the missteps during the COVID-19 pandemic to protect health care workers and how to use lessons from those mistakes for future pandemics.
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COVID-19 , Enfermedades Profesionales , Exposición Profesional , Pandemias , Humanos , COVID-19/epidemiología , COVID-19/prevención & control , COVID-19/transmisión , Personal de Salud/estadística & datos numéricos , Salud Mental , Pandemias/prevención & control , Pandemias/estadística & datos numéricos , SARS-CoV-2 , Enfermedades Profesionales/epidemiología , Enfermedades Profesionales/etiología , Enfermedades Profesionales/prevención & control , Exposición Profesional/efectos adversos , Exposición Profesional/prevención & controlRESUMEN
INTRODUCTION: Thriving from Work is defined as the state of positive mental, physical, and social functioning in which workers' experiences of their work and working conditions enable them to thrive in their overall lives, contributing to their ability to achieve their full potential at work, at home, and in the community. The purpose of this study was to develop a psychometrically-sound questionnaire measuring the positive contribution that work can have on one's well-being both at, and outside of, their work. METHODS: We used both a qualitative and quantitative approach of item reduction, domain mapping dimensionality testing, development of "long-" and "short-" versions of the questionnaire, reliability, and construct and criterion validity testing. This was established in two independent online samples of US based workers (n = 1550, n = 500). RESULTS: We developed a bi-factor model 30-item long-form and a uni-factorial 8-item short-version. The long-form measures both the latent construct of Thriving from Work and six domains (psychological/emotional; work-life integration; social; experience of work; basic needs; health). Both long- and short- forms were found to have high empirical reliability (0.93 and 0.87 respectively). The short-form captures 94% of variance of the long-form. Construct and criterion validity were supported. Test-retest reliability was high. CONCLUSIONS: The Thriving from Work Questionnaire appears to be a valid and reliable measure of work-related well-being in United States workers. Further testing is needed to refine and test the instrument in specific industries, unique worker populations, and across geographic regions.
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Calidad de Vida , Humanos , Reproducibilidad de los Resultados , Psicometría , Encuestas y Cuestionarios , Calidad de Vida/psicologíaRESUMEN
During fall 2020 in rural Pierce County, Washington, school districts and the county health department offered weekly rapid antigen screening to students and staff. Asymptomatic screening identified 42.5% of confirmed cases from the population. Parents reported it was a positive experience for their children. The program supported decisions to return to in-person learning, but screening ended because of resource and technical limitations. When planning in-school screening, stakeholder engagement and resource sustainability are important factors to consider. (Am J Public Health. 2022;112(8):1134-1137. https://doi.org/10.2105/AJPH.2022.306875).
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COVID-19 , SARS-CoV-2 , COVID-19/diagnóstico , Niño , Humanos , Instituciones Académicas , Estudiantes , Washingtón/epidemiologíaRESUMEN
Statins are a class of drug widely prescribed for the prevention of cardiovascular disease, with pleiotropic cellular effects. Statins inhibit HMG-CoA reductase (HMGCR), which converts the metabolite HMG-CoA into mevalonate. Recent discoveries have shown HMG-CoA is a reactive metabolite that can non-enzymatically modify proteins and impact their activity. Therefore, we predicted that inhibition of HMGCR by statins might increase HMG-CoA levels and protein modifications. Upon statin treatment, we observe a strong increase in HMG-CoA levels and modification of only a single protein. Mass spectrometry identifies this protein as fatty acid synthase (FAS), which is modified on active site residues and, importantly, on non-lysine side-chains. The dynamic modifications occur only on a sub-pool of FAS that is located near HMGCR and alters cellular signaling around the ER and Golgi. These results uncover communication between cholesterol and lipid biosynthesis by the substrate of one pathway inhibiting another in a rapid and reversible manner.
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Enfermedades Cardiovasculares , Inhibidores de Hidroximetilglutaril-CoA Reductasas , Enfermedades Cardiovasculares/prevención & control , Colesterol/metabolismo , Ácido Graso Sintasas , Humanos , Hidroximetilglutaril-CoA Reductasas/metabolismo , Inhibidores de Hidroximetilglutaril-CoA Reductasas/farmacología , Inhibidores de Hidroximetilglutaril-CoA Reductasas/uso terapéutico , Ácido Mevalónico/metabolismoRESUMEN
Few studies have explored the impact of rare variants (minor allele frequency < 1%) on highly heritable plasma metabolites identified in metabolomic screens. The Finnish population provides an ideal opportunity for such explorations, given the multiple bottlenecks and expansions that have shaped its history, and the enrichment for many otherwise rare alleles that has resulted. Here, we report genetic associations for 1391 plasma metabolites in 6136 men from the late-settlement region of Finland. We identify 303 novel association signals, more than one third at variants rare or enriched in Finns. Many of these signals identify genes not previously implicated in metabolite genome-wide association studies and suggest mechanisms for diseases and disease-related traits.
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Estudio de Asociación del Genoma Completo , Polimorfismo de Nucleótido Simple , Alelos , Finlandia , Frecuencia de los Genes , Predisposición Genética a la Enfermedad , Estudio de Asociación del Genoma Completo/métodos , Humanos , Masculino , FenotipoRESUMEN
The COVID-19 pandemic has highlighted the importance of work in shaping population health and wellbeing. This Viewpoint applies a multilevel systems framework to assist in understanding the diverse and complex interactions of forces affecting worker health and wellbeing, and how trending changes in employment and working conditions have been accelerated by the pandemic. Government agencies concerned with population health and wellbeing, and economic activity must expand their capacity to monitor, evaluate, and respond to these trends. In addition, integrated enterprise and workplace-based approaches that consider the interactions among these multidimensional drivers will build organisation and worker resilience to navigate the continual changes in work and worker safety, health, and wellbeing in a post-pandemic world.
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COVID-19 , Salud Laboral , Salud Pública , SARS-CoV-2 , Lugar de Trabajo , Humanos , Satisfacción Personal , PolíticaRESUMEN
Workers in nursing homes are at high risk of occupational injury. Understanding whether-and which-nursing homes implement integrated policies to protect and promote worker health is crucial. We surveyed Directors of Nursing (DON) at nursing homes in three US states with the Workplace Integrated Safety and Health (WISH) assessment, a recently developed and validated instrument that assesses workplace policies, programs, and practices that affect worker safety, health, and wellbeing. We hypothesized that corporate and for-profit nursing homes would be less likely to report policies consistent with Total Worker Health (TWH) approaches. For each of the five validated WISH domains, we assessed the association between being in the lowest quartile of WISH score and ownership status using multivariable logistic regression. Our sample included 543 nursing homes, 83% which were corporate owned and 77% which were for-profit. On average, DONs reported a high implementation of TWH policies, as measured by the WISH. We did not find an association between either corporate ownership or for-profit status and WISH score for any WISH domain. Results were consistent across numerous sensitivity analyses. For-profit status and corporate ownership status do not identify nursing homes that may benefit from additional TWH approaches.
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Propiedad , Lugar de Trabajo , Instituciones Privadas de Salud , Promoción de la Salud , Humanos , Casas de SaludRESUMEN
BACKGROUND: Many organizational interventions aim to improve working conditions to promote and protect worker safety, health, and well-being. The Workplace Organizational Health Study used process evaluation to examine factors influencing implementation of an organizational intervention. This paper examines the extent to which the intervention was implemented as planned, the dose of intervention implemented, and ways the organizational context hindered or facilitated the implementation of the intervention. METHODS: This proof-of-concept trial was conducted with a large, multinational company that provides food service through contractual arrangements with corporate clients. The 13-month intervention was launched in five intervention sites in October 2018. We report findings on intervention implementation based on process tracking and qualitative data. Qualitative data from 25 post-intervention interviews and 89 process tracking documents were coded and thematically analyzed. RESULTS: Over the 13-month intervention, research team representatives met with site managers monthly to provide consultation and technical assistance on safety and ergonomics, work intensity, and job enrichment. Approximately two-thirds of the planned in-person or phone contacts occurred. We tailored the intervention to each site as we learned more about context, work demands, and relationships. The research team additionally met regularly with senior leadership and district managers, who provided corporate resources and guidance. By assessing the context of the food service setting in which the intervention was situated, we explored factors hindering and facilitating the implementation of the intervention. The financial pressures, competing priorities and the fast-paced work environment placed constraints on site managers' availability and limited the full implementation of the intervention. CONCLUSIONS: Despite strong support from corporate senior leadership, we encountered barriers in the implementation of the planned intervention at the worksite and district levels. These included financial demands that drove work intensity; turnover of site and district managers disrupting continuity in the implementation of the intervention; and staffing constraints that further increased the work load and pace. Findings underscore the need for ongoing commitment and support from both the parent employer and the host client. TRIAL REGISTRATION: This study was retrospectively registered with the Clinical Trials. Gov Protocol and Results System on June 2, 2021 with assigned registration number NCT04913168 .
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Servicios de Alimentación , Salud Laboral , Ergonomía , Humanos , Prueba de Estudio Conceptual , Salarios y Beneficios , Lugar de TrabajoRESUMEN
Work is a major contributor to our health and well-being. Workers' thriving is directly influenced by their job design, work environment and organization. The purpose of this report is to describe the qualitative methods used to develop the candidate items for a novel measure of Thriving from Work through a multi-step iterative process including: a literature review, workshop, interviews with experts, and cognitive testing of the candidate items. Through this process, we defined Thriving from Work as the state of positive mental, physical, and social functioning in which workers' experiences of their work and working conditions enable them to thrive in their overall lives, contributing to their ability to achieve their full potential in their work, home, and community. Thriving from Work was conceptualized into 37 attributes across seven dimensions: psychological, emotional, social, work-life integration, basic needs, experience of work, and health. We ultimately identified, developed and/or modified 87 candidate questionnaire items mapped to these attributes that performed well in cognitive testing in demographically and occupationally diverse workers. The Thriving from Work Questionnaire will be subjected to psychometric testing and item reduction in future studies. Individual items demonstrated face validity and good cognitive response properties and may be used independently from the questionnaire.
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Formación de Concepto , Emociones , Humanos , Psicometría , Reproducibilidad de los Resultados , Encuestas y CuestionariosRESUMEN
BACKGROUND AND AIMS: Nursing home research may involve eliciting information from managers, yet response rates for Directors of Nursing have not been recently studied. As a part of a more extensive study, we surveyed all nursing homes in three states in 2018 and 2019, updating how to survey these leaders effectively. We focus on response rates as a measure of non-response error and comparison of nursing home's characteristics to their population values as a measure of representation error. METHODS: We surveyed Directors of Nursing or their designees in nursing homes serving adult residents with at least 30 beds in California, Massachusetts, and Ohio (N = 2389). We collected contact information for respondents and then emailed survey invitations and links, followed by three email reminders and a paper version. Nursing home associations in two of the states contacted their members on our behalf. We compared the response rates across waves and states. We also compared the characteristics of nursing homes based on whether the response was via email or paper. In a multivariable logit regression, we used characteristics of the survey and the nursing homes to predict whether their DON responded to the survey using adjustments for multiple comparisons. RESULTS: The response rate was higher for the first wave than for the second (30% vs 20.5%). The highest response rate was in Massachusetts (31.8%), followed by Ohio (25.8%) and California (19.5%). Nursing home characteristics did not vary by response mode. Additionally, we did not find any statistically significant predictors of whether a nursing home responded. CONCLUSION: A single-mode survey may provide a reasonably representative sample at the cost of sample size. With that said, however, switching modes can increase sample size without potentially biasing the sample.
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BACKGROUND: With the growth the food service industry and associated high injury and illness rates, there is a need to assess workplace factors that contribute to injury prevention. OBJECTIVE: The objective of this report is to describe the development, application, and utility of a new instrument to evaluate ergonomics and safety for food service workers. METHODS: Starting with a similar tool developed for use in healthcare, a new tool was designed through a collaborative, participatory process with the stakeholders from a collaborating food service company. The new instrument enables the identification and assessment of key safety and health factors through a focused walkthrough of the physical work environment, and structured interviews exploring the organizational work environment. The researchers applied the instrument at 10 of the partnering company's worksites. RESULTS: The instrument identified factors related to both the physical work environment and organizational and contextual environment (e.g., vendor-client relationships) impacting worker safety and health. CONCLUSIONS: Modern assessment approaches should address both the physical and organizational aspects of the work environment, and consider the context complexities in which the worksites and the industry operate.