The Work-life Check-ins randomized controlled trial: A leader-based adaptive, semi-structured burnout intervention in primary care clinics.

BACKGROUND: Burnout in primary care undermines worker well-being and patient care. Many factors contribute to burnout, including high workloads, emotional stress, and unsupportive supervisors. Formative evidence suggests that burnout might be reduced if clinic leaders hold quarterly and brief (∼30 min) one-on-one check-ins with team members to acknowledge and address work-life stressors (e.g., schedules, workflow breakdowns, time off requests). This paper describes the intervention protocol for a randomized controlled trial (RCT) designed to evaluate the effectiveness and process of the check-ins in reducing burnout among primary care professionals. METHODS: Two-arm RCT conducted at 12 primary care clinics of a healthcare system in the Pacific Northwest. Six clinics received an adaptive design, semi-structured intervention, including predefined training modules with evidence-based tactics to reduce burnout through the check-ins, followed by clinic-specific feedback sessions prior to offering and conducting quarterly leader-employee check-ins. Six clinics were randomized as waitlist controls. Burnout was measured using the Maslach Burnout Inventory (MBI) at baseline and at the 12-month follow-up. Secondary outcomes include organizational constraints, psychological safety, and supervisor support. Multilevel modeling and qualitative methods were applied to evaluate the effects and process of the intervention. CONCLUSION: By focusing on modifiable work-life factors such as stressors and supervisor support, the check-ins intervention aims to reduce burnout rates among primary care professionals. Findings from this trial will shed light on the conditions upon which check-ins might reduce burnout. Results will also inform policies and interventions aimed at improving mental health and well-being in primary care settings. CLINICALTRIALS: gov: ID NCT05436548.

Safety Responsiveness and Psychological Distress Among Health Care Workers During COVID-19 (2020-2022) in the Pacific Northwest.

Objectives. The COVID-19 pandemic imposed unprecedented safety challenges on health care facilities. This study examined whether health care workers who deemed a better safety response to the pandemic by their units or employers experienced lower psychological distress. Methods. Patient care workers at a health care system in the Pacific Northwest were surveyed every 6 to 8 months from May 2020 to May 2022 (n = 3468). Psychological distress was measured with the Well-being Index (range: -2 to 7 points). Safety response was scored on the basis of participants' ratings (on a 1-5 scale) of equipment sufficiency and responsiveness to safety concerns by their health care system and unit. Results. Adjusted multilevel regressions showed an inverse association between safety responsiveness and psychological distress at the individual level (b = -0.54; 95% confidence interval [CI] = -0.67, -0.41) and the unit level (b = -0.73; 95% CI = -1.46, -0.01). The cross-level interaction was also statistically significant (b = -0.46; 95% CI = -0.87, -0.05). Conclusions. Health care workers who deemed a better response to safety challenges reported lower psychological distress. This study highlights the need for continued efforts to ensure adequate safety resources. (Am J Public Health. 2024;114(S2):S204-S212. https://doi.org/10.2105/AJPH.2024.307582).

Employee Cardiometabolic Risk Following a Cluster-Randomized Workplace Intervention From the Work, Family and Health Network, 2009-2013.

Objectives. To examine whether workplace interventions to increase workplace flexibility and supervisor support and decrease work-family conflict can reduce cardiometabolic risk. Methods. We randomly assigned employees from information technology (n = 555) and long-term care (n = 973) industries in the United States to the Work, Family and Health Network intervention or usual practice (we collected the data 2009-2013). We calculated a validated cardiometabolic risk score (CRS) based on resting blood pressure, HbA1c (glycated hemoglobin), HDL (high-density lipoprotein) and total cholesterol, height and weight (body mass index), and tobacco consumption. We compared changes in baseline CRS to 12-month follow-up. Results. There was no significant main effect on CRS associated with the intervention in either industry. However, significant interaction effects revealed that the intervention improved CRS at the 12-month follow-up among intervention participants in both industries with a higher baseline CRS. Age also moderated intervention effects: older employees had significantly larger reductions in CRS at 12 months than did younger employees. Conclusions. The intervention benefited employee health by reducing CRS equivalent to 5 to 10 years of age-related changes for those with a higher baseline CRS and for older employees. Trial Registration. ClinicalTrials.gov Identifier: NCT02050204. (Am J Public Health. 2023;113(12):1322-1331. https://doi.org/10.2105/AJPH.2023.307413).

Multidimensionality of the PROMIS sleep disturbance 8b short form in working adult populations.

OBJECTIVES: The Patient-Reported Outcomes Measurement Information System sleep disturbance measures were developed using item response theory assumptions of unidimensionality and local independence. Given that sleep health is multidimensional, we evaluate the factor structure of the Patient-Reported Outcomes Measurement Information System sleep disturbance 8b short form to examine whether it reflects a unidimensional or multidimensional construct. METHODS: Six full-time working adult samples were collected from civilian and military populations. Exploratory and confirmatory factor analyses were conducted. Single-factor and two-factor models were performed to evaluate the dimensionality of sleep disturbance using the 8b short form. Sleep duration and subjective health were examined as correlates of the sleep disturbance dimensions. RESULTS: Across six working adult samples, single-factor models consistently demonstrated poor fit, whereas the two-factor models, with insomnia symptoms (ie, trouble sleeping) and dissatisfaction with sleep (ie, subjective quality of sleep) dimensions demonstrated sufficient fit that was significantly better than the single-factor models. Across each sample, dissatisfaction with sleep was more strongly correlated with sleep duration and subjective health than insomnia symptoms, providing additional evidence for distinguishability between the two sleep disturbance factors. CONCLUSIONS: In working adult populations, the Patient-Reported Outcomes Measurement Information System sleep disturbance 8b short form is best modeled as two distinguishable factors capturing insomnia symptoms and dissatisfaction with sleep, rather than as a unidimensional sleep disturbance construct.

The effects of a Total Worker Health intervention on workplace safety: Mediating effects of sleep and supervisor support for sleep.

We tested the effects of a randomized controlled trial Total Worker Health intervention on workplace safety outcomes. The intervention targeted employee sleep at both the supervisor-level (e.g., sleep-specific support training) and employee-level (e.g., sleep tracking and individualized sleep feedback). The intervention components were developed using principles of the Total Worker Health approach and the theory of triadic influence for health behaviors. We hypothesized that employees in the treatment group would report greater safety compliance, safety participation, and safety motivation, and would be less likely to experience a work-related accident or injury following the intervention through improvements in sleep quantity and quality, as well as increased perceptions of supervisors' support for sleep. It was theorized that the indirect effects of the intervention on workplace safety outcomes via sleep mediators operated through a resource pathway, whereas the supervisor support for sleep mediator operated through an exchange pathway. Results broadly revealed that employees in the treatment group, compared to those in the control group, reported greater workplace safety behaviors and safety motivation, and reduced workplace accidents and injuries 9 months post-baseline, through lower dissatisfaction with sleep, reduced sleep-related impairments, and greater supervisor support for sleep 4 months post-baseline. Intervening on sleep and supervisor support for sleep in an integrated Total Worker Health framework can have a positive impact on workplace safety. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Family-Supportive Supervisor Behaviors and Psychological Distress: A Secondary Analysis across Four Occupational Populations.

This study assessed the associations of employee's perceptions of family-supportive supervisor behaviors (FSSB) and their psychological distress across four occupational populations (n = 3778): Information technology; healthcare; military-connected Veterans; and National Guard service members. Data were gathered and analyzed from four larger archival datasets to compare differences in these relationships. Results revealed significant negative relationships between employee reports of FSSB and their psychological distress within occupations, as expected. Furthermore, results revealed significant differences across occupational populations for employee reports of both FSSB and psychological distress. Hierarchical moderated multiple regression analyses were conducted to examine the extent of these mean differences across groups. Results revealed significant differences among these four groups such that the military-connected Veteran employees demonstrated significantly stronger associations of FSSB, and psychological distress compared to the other three occupations of information technology, healthcare, and National Guard service members. These findings suggest the importance of FSSB to worker psychological health across a variety of occupational populations, specifically noting the importance and presence of FSSB for Veteran employees' psychological distress in civilian workplaces. Practical implications include the need for training leaders on how to better support employees' work and non-work lives, mental health, and well-being.

A Comparison of Safety, Health, and Well-Being Risk Factors Across Five Occupational Samples.

Objective: The aim of this study was to present safety, health and well-being profiles of workers within five occupations: call center work (N = 139), corrections (N = 85), construction (N = 348), homecare (N = 149), and parks and recreation (N = 178). Methods: Baseline data from the Data Repository of Oregon's Healthy Workforce Center were used. Measures were compared with clinical healthcare guidelines and national norms. Results: The prevalence of health and safety risks for adults was as follows: overweight (83.2%), high blood pressure (16.4%), injury causing lost work (9.9%), and reported pain (47.0%). Young workers were least likely to report adequate sleep (46.6%). Construction workers reported the highest rate of smoking (20.7%). All of the adult workers reported significantly lower general health than the general population. Conclusion: The number of workers experiencing poor safety, health and well-being outcomes suggest the need for improved working conditions.

Effects of a Total Worker Health® leadership intervention on employee well-being and functional impairment.

Although evidence has been mounting that supervisor support training interventions promote employee job, health, and well-being outcomes, there is little understanding of the mechanisms by which such interventions operate (e.g., Hammer et al., 2022; Inceoglu et al., 2018), nor about the integration of such organizational-level interventions with individual-level interventions (e.g., Lamontagne et al., 2007). Thus, the present study attempts to unpack the mechanisms through which supervisor support training interventions operate. In addition, the present study examines an integrated Total Worker Health® intervention that combines health protection in the form of supervisor support training (i.e., family supportive supervisor behaviors and supervisor support for sleep health) with a health promotion approach in the form of feedback to improve sleep health behaviors. Using a cluster randomized controlled trial drawing on a sample of 704 full-time employees, results demonstrate that the Total Worker Health intervention improves employee job well-being (i.e., increased job satisfaction and reduced turnover intentions), personal well-being (i.e., reduced stress before bedtime), and reduces personal and social functional impairment at 9 months postbaseline through employee reports of supervisors' support for sleep at 4 months postbaseline, but not through family supportive supervisor behaviors. Effects were not found for general stress or occupational functional impairment outcomes. Implications are discussed, including theoretical mechanisms by which leadership interventions affect employees, supervisor training, as well as the role of integrated organizational and individual-level interventions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Supportive supervisor training improves family relationships among employee and spouse dyads.

Employee family relationships have been increasingly tied to job outcomes and are known to be a strong predictor of employee health and well-being. As such, taking steps toward uncovering actionable tools organizations can implement to foster improvements in family relationship quality is important and should not be overlooked in occupational health psychology interventions. Supportive supervisor training (SST) targets improving employees' ability to meet their nonwork needs; however, the focus and discussions of the implications tied to SST have largely excluded marital and parent-child relationships, spouses, and spousal outcomes. Further, mounting evidence suggests contextual factors shape when SST is most meaningful; however, more research is needed to uncover individual-level factors that may facilitate training effects. This study used a cluster-randomized controlled trial design to evaluate a worksite-based SST with a sample of 250 employees (separated military veterans) and their matched spouses. Using an intent-to-treat approach and 2-level random effects models, results demonstrated that the SST promoted couples' dyadic marital relationship quality 9 months following baseline. Additionally, when employees were under higher levels of baseline stress, couples' dyadic marital relationship quality and positive parenting both improved following the SST. Thus, an SST is beneficial for family relationships as reported by both employees and spouses, which goes beyond previously demonstrated employee health and well-being benefits. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Can supervisor support improve daily employee well-being? Evidence of supervisor training effectiveness in a study of veteran employee emotions.

Workplace supportive supervisor interventions offer an effective, though underutilized mechanism to bolster employee well-being, which may have important benefits particularly for understudied groups such as military veterans in the civilian workforce. The present study employed a two-wave daily diary study to test the effectiveness of a supportive supervisor training on positive and negative emotions of veteran employees. Daily diaries are instrumental to understanding well-being, in that they accurately capture emotions as they are experienced without retrospective biases that reflect more global emotional assessments. Each wave (baseline and 6 months later) comprised emotion reports over 32-day periods. Thirty-five organizations were randomized into intervention and control groups; 144 veterans (91% men) participated in the daily diaries at baseline. The training significantly improved well-being facets including improvements in unactivated positive (i.e., calm) emotions at follow-up. Two significant moderation effects were also revealed for PTSD screening. For veteran employees with positive PTSD screens, the intervention functioned to reduce negative emotions. For those employees with negative PTSD screens, the intervention enhanced positive emotions. Our work highlights the benefit of workplace supervisor support to positive and negative employee mood.

Perceived partner responsiveness, pain, and sleep: A dyadic study of military-connected couples.

OBJECTIVE: The health-promoting influence of supportive close relationships has been extensively documented, yet the mechanisms of this effect are still being clarified. Leading researchers have theorized that examining particular interpersonal interactions and the mediating intrapersonal processes they facilitate is the key to understanding how close relationships benefit health. The purpose of this study was to investigate the influence of perceived partner responsiveness (PPR) on pain and sleep quality via affect in a sample of veterans and spouses (collectively called military-connected couples). METHOD: Military-connected couples (N = 162) completed 32 days of daily diaries. Mediated actor-partner interdependence models were conducted using multilevel structural equation modeling to assess the effects of PPR at baseline on the daily levels of positive affect, negative affect, pain, and sleep across the following 32 days. RESULTS: Indirect effects emerged such that affect mediated the association between PPR and pain for veterans only whereas affect mediated the association between PPR and sleep quality for both partners. Daily direct effects emerged as well; for example, positive affect was positively associated with higher sleep quality for both partners and lower pain for veterans. Partner effects were revealed such as veteran PPR was positively associated with spouse positive affect. Overall, greater PPR was associated with positive health outcomes for military-connected couples. CONCLUSION: The implications of this study include providing insights for couple-oriented interventions for preventing and treating pain and sleep problems in couples who are at high risk of these health problems such as military-connected couples. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Occupational Health Science in the Time of COVID-19: Now more than Ever.

Workers bear a heavy share of the burden of how countries contend with COVID-19; they face numerous serious threats to their occupational health ranging from those associated with direct exposure to the virus to those reflecting the conflicts between work and family demands. Ten experts were invited to comment on occupational health issues unique to their areas of expertise. The topics include work-family issues, occupational health issues faced by emergency medical personnel, the transition to telework, discrimination against Asian-Americans, work stressors, presenteeism, the need for supportive supervision, safety concerns, economic stressors, and reminders of death at work. Their comments describe the nature of the occupational health concerns created by COVID-19 and discuss both unanswered research questions and recommendations to help organizations reduce the impacts of COVID-19 on workers.

Education and Training to Build Capacity in Total Worker Health®: Proposed Competencies for an Emerging Field.

OBJECTIVE: Establishment of core competencies for education and training of professionals entering the emerging field of Total Worker Health®. METHODS: Compilation and distillation of information obtained over a 5-year period from Total Worker Health symposia, workshops, and academic offerings, plus contributions from key stakeholders regarding education and training needs. RESULTS: A proposed set of Total Worker Health competencies aligns under six broad domains: Subject Matter Expertize; Advocacy and Engagement; Program Planning, Implementation and Evaluation; Communications and Dissemination; Leadership and Management; and Partnership Building and Coordination. CONCLUSIONS: Proposed set of core competencies will help standardize education and training for professionals being trained in Total Worker Health. It serves as an invitation for further input from stakeholders in academia, business, labor, and government.

Associations among patient care workers' schedule control, sleep, job satisfaction and turnover intentions.

Healthcare is the fastest growing occupational sector in America, yet patient care workers experience low job satisfaction, high turnover, and susceptibility to poor sleep compared to workers in other jobs and industries. Increasing schedule control may be one way to help mitigate these issues. Drawing from conservation of resources theory, we evaluate associations among schedule control (i.e. a contextual resource), employee sleep duration and quality (i.e. personal resources), job satisfaction, and turnover intentions. Patient care workers who reported having more schedule control at baseline reported greater sleep duration and sleep quality 6 months later, as well as higher job satisfaction and lower turnover intentions 12 months later. Workers who experienced greater sleep sufficiency (i.e. feeling well-rested) reported higher job satisfaction 6 months later, and workers who experienced fewer insomnia symptoms (i.e. trouble falling and staying asleep) reported lower turnover intentions 6 months later. The association between schedule control and job satisfaction was partially mediated by greater sleep sufficiency, though this effect was small. Providing patient care workers with greater control over their work schedules and opportunities for improved sleep may improve their job attitudes. Results were not replicated when different analytical approaches were performed, so findings should be interpreted provisionally.

The relationship between leadership support and employee sleep.

Sleep is critical to employees' health and well-being, safety, and performance at work. Sleep leadership refers to supervisor behaviors that aim to improve employees' sleep, such as showing concern for the quantity and quality of employees' sleep. Using a sample of 180 employees and their 91 supervisors working as full-time National Guard military service members, we examined the relationship of sleep leadership and family-supportive supervisor behaviors (FSSB) to employees' sleep. As outcomes we measured objective sleep quality and quantity using validated wrist actigraphy methods, as well as self-reported sleep hygiene, subjective sleep quantity, and subjective sleep quality (sleep disturbance and sleep-related impairment). As a novel contribution to the literature, we included both supervisors' self-reports and employees' reports of supervisors' engagement in sleep leadership and FSSB. Contradicting our hypotheses, our results show that higher employee ratings of FSSB were related to shorter objective sleep time. Regarding self-reported sleep outcomes, higher employees' ratings of sleep leadership were associated with less sleep disturbance and less sleep-related impairment among employees. Higher supervisors' self-ratings of FSSB, in turn, were related to better sleep hygiene and less sleep-related impairment among employees. Overall, our study demonstrates the importance of supportive supervisor behaviors for employees' sleep quality. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Military sexual trauma among women Veterans: The buffering effect of coworker support.

Prior research has demonstrated the impact of military sexual trauma (MST) on health and well-being. However, little empirical work has been published identifying protective factors for women who have experienced MST. We examined the impact of two different forms of MST, harassment-only and assault MST, on PTSD symptoms and social functional impairment in a sample of women Veterans employed in the civilian workforce. The effects of MST were examined at three different times over a period of 9 months. We found that MST that included both harassment and assault was associated with significantly higher levels of PTSD symptoms and social functional impairment across three different time points among women Veterans employed in civilian jobs. Further, the pattern of results suggested that coworker support can buffer against these negative outcomes experienced by women who reported assault MST. Overall, findings suggest that coworker support is one critical resource for women Veterans who experienced assault MST.