Importance of social and cultural factors for attitudes, disclosure and time off work for depression: findings from a seven country European study on depression in the workplace.
ABSTRACT: OBJECTIVES: Depression is experienced by a large proportion of the workforce and associated with high costs to employers and employees. There is little research on how the social costs of depression vary by social and cultural context. This study investigates individual, workplace and societal factors associated with greater perceived discomfort regarding depression in the workplace, greater likelihood of employees taking time off of work as a result of depression and greater likelihood of disclosure of depression to one's employer. METHODS: Employees and managers (n = 7,065) were recruited from seven European countries to participate in the IDEA survey. Multivariable logistic regression models were used to examine associations between individual characteristics and country contextual characteristics in relation to workplace perceptions, likelihood of taking time off work and disclosing depression to an employer. RESULTS: Our findings suggest that structural factors such as benefit systems and flexible working hours are important for understanding workplace perceptions and consequences for employees with depression. However, manager responses that focus on offering help to the employee with depression appear to have stronger associations with positive perceptions in the workplace, and also with openness and disclosure by employees with depression. CONCLUSION: This study highlights the importance of individual, workplace and societal factors that may be associated with how people with depression are perceived and treated in the workplace, and, hence, factors that may be associated with openness and disclosure among employees with depression. Some responses, such as flexible working hours, may be helpful but are not necessarily sufficient, and our findings also emphasise the importance of support and openness of managers in addition to flexible working hours.
Project description:BACKGROUND:Poor physical and mental health of employees create significant problems in the workplace. Physical activity (PA) has been shown as an effective strategy for preventing and treating numerous physical and mental health issues as well as work performance outcomes. However, there are many barriers to taking part in PA (such as lack of time) with participation rates typically low. Providing PA in paid work time might be a way to overcome these issues, yet employers' and employees' opinions of this concept are unknown. The aim of this study was to explore employee and employer perspectives of PA in paid work time. METHODS:Workplaces were recruited through existing contacts on the research team. Focus groups and interviews were conducted with employees and managers at one University and two executive non-departmental public bodies in central Scotland with mainly desk-based employees. Both managers and employees were involved to gain perspectives throughout the organisational hierarchy and were interviewed separately to reduce social desirability bias. All discussions were digitally recorded and transcribed verbatim. Data were analysed thematically for both managers and employees but due to significant overlap in themes between the groups, these are reported together in the results. RESULTS:Three out of five organisations approached took part in this qualitative study. Two individual interviews were held with strategic managers, five focus groups with middle managers (n?=?16) and nine with employees (n?=?45). Benefits were anticipated by managers and employees for both employees themselves and the organisation and included improved mental health, productivity and more favourable perceptions of the employer. Despite these widely acknowledged benefits, significant barriers were identified and included the structure and nature of the working day (high workload, front line job requirements), workplace culture and norms (resentment from colleagues, no break culture) and organisational concerns (cost of lost time, public perceptions). CONCLUSION:This study suggests that there are significant barriers to PA in paid work time. Whilst numerous anticipated benefits were conveyed by both employees and managers, PA in paid work time is unlikely to become common place until changes in attitudes and the culture towards movement at work occur.
Project description:OBJECTIVE:This study addresses older employees' trajectories of perceived workplace age discrimination, and the long-term associations among perceived age discrimination and older workers' mental and self-rated health, job satisfaction, and likelihood of working past retirement age. We evaluate the strength and vulnerability integration (SAVI) model. METHOD:Three waves of data from employed participants were drawn from the Health and Retirement Study (N = 3,957). Latent growth modeling was used to assess relationships between the slopes and the intercepts of the variables, thereby assessing longitudinal and cross-sectional associations. RESULTS:Perceived workplace age discrimination tends to increase with age, although notable variance exists. The initial status of perceived age discrimination relates to the baseline statuses of depression, self-rated health, job satisfaction, and likelihood of working past retirement age in the expected directions. Over time, perceived age discrimination predicts lower job satisfaction and self-rated health, as well as elevated depressive symptoms, but not likelihood of working past retirement age. DISCUSSION:This study provides empirical support for the SAVI model and uncovers the "wear and tear" effects of perceived workplace age discrimination on older workers' mental and overall health. We deliberate on social policies that may reduce age discrimination, thereby promoting older employees' health and ability to work longer.
Project description:BACKGROUND: The role of workplaces in promoting active travel (walking, cycling or using public transport) is relatively unexplored. This study explores the potential for workplaces to reduce employees' driving to work in order to inform the development of workplace interventions for promoting active travel. METHODS: An analysis of a cross-sectional survey was conducted using data from parents/guardians whose children participated in the Central Sydney Walk to School Program in inner-west Sydney, Australia. A total of 888 parents/guardians who were employed and worked outside home were included in this analysis. The role of the workplace in regards to active travel was assessed by asking the respondents' level of agreement to eight statements including workplace encouragement of active travel, flexible working hours, public transport availability, convenient parking, shower and change rooms for employees and whether they lived or worked in a safe place. Self-reported main mode of journey to work and demographic data were collected through a self-administrated survey. Binary logistic regression modelling was used to ascertain independent predictors of driving to work. RESULTS: Sixty nine per cent of respondents travelled to work by car, and 19% agreed with the statement, "My workplace encourages its employees to go to and from work by public transport, cycling and/or walking (active travel)." The survey respondents with a workplace encouraging active travel to work were significantly less likely to drive to work (49%) than those without this encouragement (73%) with an adjusted odds ratio (AOR) of 0.41 (95% CI 0.23-0.73, P = 0.002). Having convenient public transport close to the workplace or home was also an important factor that could discourage employees from driving to work with AOR 0.17 (95% CI 0.09-0.31, P < 0.0001) and AOR 0.50 (95% CI 0.28-0.90, P = 0.02) respectively. In contrast, convenient parking near the workplace significantly increased the likelihood of respondents driving to work (AOR 4.6, 95% CI 2.8-7.4, P < 0.0001). CONCLUSIONS: There is a significant inverse association between the perception of workplace encouragement for active travel and driving to work. Increases in the number of workplaces that encourage their employees to commute to work via active travel could potentially lead to fewer employees driving to work. In order to make active travel more appealing than driving to work, workplace interventions should consider developing supportive workplace policies and environments.
Project description:Routine annual influenza vaccinations are recommended for persons 6 months of age and older, but less than half of US adults get vaccinated. Many employers offer employees free influenza vaccinations at workplace clinics, but even then take-up is low.To determine whether employees are significantly more likely to get vaccinated if they have a higher probability of walking by the clinic for reasons other than vaccination.We obtained data from an employer with a free workplace influenza vaccination clinic. Using each employee's building entry/exit swipe card data, we test whether functional proximity-the likelihood that the employee walks by the clinic for reasons other than vaccination-predicts whether the employee gets vaccinated at the clinic. We also test whether base proximity-the inverse of walking distance from the employee's desk to the clinic-predicts vaccination probability.A total of 1801 employees of a health benefits administrator that held a free workplace influenza vaccination clinic.A 2 SD increase in functional proximity is associated with a 6.4 percentage point increase in the probability of vaccination (total vaccination rate at company=40%), even though the average employee's desk is only 166 meters from the clinic. Base proximity does not predict vaccination probability.Minor changes in the environment can have substantial effects on the probability of vaccination. If these results generalize, health systems should emphasize functional proximity over base proximity when locating preventive health services.
Project description:PURPOSE:To review enrollment strategies, participation barriers, and program reach of a large, 2-year workplace intervention targeting sedentary behavior. APPROACH:Cross-sectional, retrospective review. SETTING:Twenty-four worksites balanced across academic, industry, and government sectors in Minneapolis/Saint Paul (Minnesota) and Phoenix (Arizona) regions. PARTICIPANTS:Full-time (?30+ h/wk), sedentary office workers. METHODS:Reach was calculated as the proportion of eligible employees who enrolled in the intervention ([N enrolled/(proportion of eligible employees × N total employees)] × 100). Mean (1 standard deviation) and median worksite sizes were calculated at each enrollment step. Participation barriers and modifications were recorded by the research team. A survey was sent to a subset of nonparticipants (N = 57), and thematic analyses were conducted to examine reasons for nonparticipation, positive impacts, and negative experiences. RESULTS:Employer reach was 65% (56 worksites invited to participate; 66% eligible of 56 responses; 24 enrolled). Employee reach was 58% (1317 invited to participate, 83% eligible of 906 responses; 632 enrolled). Postrandomization, on average, 59% (15%) of the worksites participated. Eighteen modifications were developed to overcome participant-, context-, and research-related participation barriers. CONCLUSION:A high proportion of worksites and employees approached to participate in a sedentary behavior reduction intervention engaged in the study. Interventions that provide flexible enrollment, graded participant engagement options, and adopt a participant-centered approach may facilitate workplace intervention success.
Project description:Purpose Employer policies and practices have been shown to impact workplace disability, but research in this area has waned in recent years despite an aging workforce, a growing prevalence of chronic health conditions, and a larger proportion of working-age adults on permanent work disability in many jurisdictions. The purpose of this article is to describe the background rationale and methodology for an invited conference designed to improve research of employer strategies to curtail work disability. Methods A multidisciplinary team of 26 international researchers with published research in employer-based disability management or related fields were invited to attend a 3-day conference in Hopkinton, Massachusetts, USA. The overall goal was to review the status of current research of workplace disability management and prevention, examine its relevance for employer decision-making, compare conceptual frameworks or theoretical perspectives, and recommend future research directions. Working groups were organized and draft manuscripts were prepared in advance. Conference activities included working group presentations and critiques, discussions with a panel of industry consultants and advisors, group interaction and debate, generation of final recommendations, and manuscript revision. Results/Conclusion Six principal domains were established with respect to future research: (a) further elucidation of the key workplace factors that buffer the disabling effects of injury and illness; (b) more innovative and feasible options for workplace intervention; (c) measurement of workplace-relevant disability outcomes; (d) a stronger theoretical framework for understanding the factors behind employer uptake and implementation; (e) a focus on special clinical populations and occupations where disability risk is most troubling; and (f) better representation of workers and employers that reflect the diverse and changing nature of work. Final comments and recommendations of the working groups are presented in the following six articles in this special issue of the Journal of Occupational Rehabilitation. Conference attendees recommended changes in methodology, collaboration strategies, and theoretical perspectives to improve the practical and scientific impact of future research of employer practices.
Project description:OBJECTIVES:This study examined the association between workplace rules and training programs regarding combining employees' work and treatment for chronic diseases, and actions actually taken by employees to manage this issue. These workplace measures (rules and training programs) are consistent with the Japanese Guideline for Workplace Patient Coordination and Disease Treatment. METHODS:In February 2018, we conducted an online, cross-sectional survey of 1134 employed individuals with chronic diseases who needed workplace support to combine work and disease treatment. All participants were aged 18-65 years and lived in Japan. We investigated associations between workplace rules and training programs (two items) and employee actions (eight items), using a questionnaire based on the guideline and logistic regression analysis. RESULTS:In total, 76.5% of the participants said they had reported their chronic disease to their employer (manager, personnel department, or occupational physician). However, less than half (47.5%) had submitted a written report about their job to their doctor. Employees were more likely to take action in workplaces that had rules or training programs than in workplaces without such measures. More actions were taken among employees in workplaces with both rules and training programs than in those with either measure alone. CONCLUSION:It is important to establish rules to support employees with chronic diseases and provide training to improve awareness of these rules to encourage employees with chronic diseases to take action to access the support they need.
Project description:BACKGROUND:The number of people of working age suffering from chronic disease is increasing. Chronic diseases such as diabetes can cause negative work-related consequences in the form of early retirement or absenteeism. Providing flexible workplace accommodations may enable the person with diabetes to retain their position in the labor market. However, the successfulness of such accommodations depends largely on the perceptions of those not suffering from diabetes. The purpose of this study was to examine preferences of a population of workers in Denmark for flexibility at the workplace, for people with diabetes and for people with chronic disease in general, measured as their willingness to pay (WTP). METHODS:Respondents were drawn from online panels and randomized to answer an online survey regarding flexibility at the workplace for people with diabetes or chronic disease in general. One thousand one hundred and three respondents were included in the analysis. Based on discrete choice experiments included in the survey, we analyzed WTP for five flexibility attributes: part-time, customizing job description, additional break with pay and time off for medical visits with and without pay. We further examined perceptions of the employer's responsibility to ensure workplace flexibility for five different specific chronic diseases including diabetes. Finally, we analyzed differences in WTP for flexibility across subgroups. RESULTS:Respondents' WTP was significantly higher for chronic disease in general compared to diabetes for the possibility of part-time (81€/month vs. 47€/month, p < 0.001) and customizing job description (58€/month vs. 41€/month, p = 0.018) attributes, as well as for the overall average (49€/month vs. 36€/month, p = 0.008). Ensuring workplace flexibility for patients with a specific chronic disease other than diabetes (cancer, heart disease, arthritis and COPD) was to a higher degree considered a responsibility of the employer. Average WTP for flexibility varied across subgroups, consistently yielding a larger amount for chronic disease in general. CONCLUSIONS:The population examined in this study are willing to pay less for flexibility at the workplace for people with diabetes compared to people with chronic disease in general. This finding was evident in terms of specific flexibility attributes and on average across subgroups.
Project description:BACKGROUND:Internet-based cognitive behavioral therapy (ICBT) for mental health issues has been successfully implemented in routine health care settings, and research indicates that ICBT can also be applied to decrease problematic alcohol use in workplace settings. However, studies investigating the feasibility of implementing ICBT in a workplace setting have been lacking. OBJECTIVE:The current study aims to investigate the feasibility of delivering ICBT for problematic alcohol use within an employee assistance program (EAP). METHODS:The study has a quantitative naturalistic design, quantitively comparing ICBT and face-to-face treatment, and allowing for qualitative interviews with employees and employers. Recruitment of participants follows a five-session in-person psychological assessment at an EAP regarding an employee's presumed problematic alcohol consumption. All assessed employees referred to ICBT or face-to-face treatment will be offered participation in the study. Interviews will be held with employees and their employer representatives following ICBT to elucidate both stakeholders' experience and perception of ICBT and its context. Outcome comparisons between ICBT and face-to-face treatment will be assessed quantitatively using a Reliable Change Index and analysis of variance. Thematic analysis and Grounded Theory will be used to analyze the interview material. RESULTS:The study is set to begin in April 2020 and to end in September 2021. The aim is to recruit up to 150 participants to the quantitative part of the study and 45 participants (15 employees and 30 employer representatives) to the qualitative part of the study. CONCLUSIONS:The current study will provide knowledge that is lacking and urgently needed on how to implement ICBT for problematic alcohol use in a workplace setting. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID):PRR1-10.2196/18693.
Project description:<h4>Purpose</h4>To examine the reliability and validity of a brief measure (the Workplace Support for Health [WSH] scale) to assess employees' perceived support for a healthy lifestyle.<h4>Design</h4>Repeated cross-sectional surveys.<h4>Setting</h4>We collected employer- and employee-level survey data from small, low-wage workplaces in King County, WA enrolled in a randomized controlled trial.<h4>Sample</h4>We analyzed data from 68 workplaces that had 2,820 and 2,640 employees complete surveys at baseline and 15 months, respectively.<h4>Measures</h4>The WSH scale consisted of five items. To assess validity, we examined associations between the WSH scale and employer implementation of evidence-based interventions for health promotion, employee self-rated health, and job satisfaction.<h4>Analysis</h4>We performed an exploratory factor analysis to assess the unidimensionality of the WSH scale items, and produced Cronbach's alpha coefficients to examine scale reliability. We ran regression models using generalized estimating equations to examine validity.<h4>Results</h4>The factor analysis indicated one factor, which accounted for 59% of the total variance in the workplace support for health items. The scale had good reliability at baseline (? = 0.82) and 15 months (? = 0.83). Employer evidence-based intervention implementation was positively associated with WSH. WSH was also associated with higher self-rated health and job satisfaction. These associations indicate good concurrent validity.<h4>Conclusion</h4>The WSH scale is a reliable and valid measure of perceived workplace support for health. Employers can use the scale to identify gaps in support and create a plan for improvement.