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Leso V, Carugno M, Carrer P, Fusco F, Mendola M, Coppola M, Zaffina S, Di Prinzio RR, Iavicoli I. The Total Worker Health® (TWH) approach: a systematic review of its application in different occupational settings. BMC Public Health 2024; 24:2037. [PMID: 39080673 PMCID: PMC11287918 DOI: 10.1186/s12889-024-19500-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Accepted: 07/16/2024] [Indexed: 08/03/2024] Open
Abstract
BACKGROUND The National Institute for Occupational Safety and Health (NIOSH), in 2011, developed the "Total Worker Health®" (TWH) as a holistic approach to protect and promote the workers' safety, health, and well-being. After over ten years from the TWH development, the aim of the present systematic review is to provide a comprehensive overview of the worldwide TWH initiatives. METHODS PubMed, Scopus and ISI Web of Science were searched for TWH studies published up to the 31st of July 2023, and 43 investigations could be included. The review was registered on the International prospective register of systematic reviews PROSPERO with the reference number CRD42023416972. RESULTS Issues that emerged as relevant for the TWH operationalization were the awareness about the TWH approach and fundamentals, the leadership commitment, and a participatory engagement of the workforce: these aspects all contributed to acceptable and effective setting oriented TWH plans, specifically tailored on the peculiarities of the workplace, including small enterprises and multiemployer worksites. Evaluation and continual improvement were reported as fundamental for the successful implementation of TWH initiatives. Limited resources for safety and health initiatives, in terms of time, people, and funds, together with difficulties in the identification of safety and health priorities and a poor participatory culture were recognized as obstacles to the TWH application. Training resulted the core component of the TWH leadership and workforce preparedness, with beneficial results in terms of safety culture and adoption of preventive measures. CONCLUSIONS Although interesting aspects emerged from our review, future longitudinal investigations should confirm the effectiveness, easy integration, and long-term sustainability of TWH models in different workplaces, in order to effectively support safe and health-enhancing works able to improve innovation and productivity.
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Affiliation(s)
- Veruscka Leso
- Department of Public Health, Section of Occupational Medicine, University of Naples Federico II, Via S. Pansini 5, 80131, Naples, Italy
| | - Michele Carugno
- Department of Clinical Sciences and Community Health, University of Milan, Via San Barnaba 8, 20122, Milan, Italy
- Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via San Barnaba 8, 20122, Milan, Italy
| | - Paolo Carrer
- Occupational Health Unit, Fatebenefratelli-Sacco University Hospital, Via G.B. Grassi 74, 20157, Milan, Italy
- Department of Biomedical and Clinical Sciences, University of Milan, Via G.B. Grassi 74, 20157, Milan, Italy
| | - Fabio Fusco
- Department of Public Health, Section of Occupational Medicine, University of Naples Federico II, Via S. Pansini 5, 80131, Naples, Italy
| | - Marco Mendola
- Occupational Health Unit, Fatebenefratelli-Sacco University Hospital, Via G.B. Grassi 74, 20157, Milan, Italy
| | - Mariagaia Coppola
- Department of Public Health, Section of Occupational Medicine, University of Naples Federico II, Via S. Pansini 5, 80131, Naples, Italy
| | - Salvatore Zaffina
- Occupational Medicine Unit, IRCCS Bambino Gesù Children's Hospital, Piazza S.Onofrio, 4, Rome, 00165, Italy
| | - Reparata Rosa Di Prinzio
- Occupational Medicine Unit, IRCCS Bambino Gesù Children's Hospital, Piazza S.Onofrio, 4, Rome, 00165, Italy
- Alta Scuola Di Economia E Management Dei Sistemi Sanitari (ALTEMS), Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, Rome, 00168, Italy
| | - Ivo Iavicoli
- Department of Public Health, Section of Occupational Medicine, University of Naples Federico II, Via S. Pansini 5, 80131, Naples, Italy.
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Keller EG, Hittle BM, Boch S, Davis K, Gillespie GL. Modeling wellbeing for U.S. correctional nurses: A cross sectional survey. Int J Nurs Stud 2023; 147:104589. [PMID: 37741259 DOI: 10.1016/j.ijnurstu.2023.104589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 08/11/2023] [Accepted: 08/14/2023] [Indexed: 09/25/2023]
Abstract
BACKGROUND Nurses work in stressful environments, and this stress has negative consequences on health. Correctional nurses experience unique job stress in their roles. However, there has been limited research exploring how the correctional environment impacts nurse health and wellbeing. OBJECTIVE This study aimed to evaluate the relationship between the variables of organizational characteristics (i.e., job demands, job control, manager support, peer support, workplace relationships), job stress, and wellbeing levels in a sample of U.S. correctional nurses, while exploring socio-demographic covariates. METHODS Using a convenience sampling method, 270 U.S. correctional nurses completed a cross-sectional online survey. Informed by the Job Demands-Resources Theory, a conceptual model was created and tested in this sample. Analysis involved multiple linear regression and structural equation modeling. RESULTS The model significantly fit the data (CI: 0.71-0.83, CFI = 0.51, SRMR: 0.37, and RMSEA = 0.08) revealing the direct relationship between job stress, job demands, job control, and workplace relationships and wellbeing. This study also provided evidence that job stress mediates the relationship of job control and job demands with wellbeing. CONCLUSION Results underscore the opportunity for correctional organizations to consider targeting job demands, job control, workplace relationships, and job stress in future interventions to improve the correctional nursing work environment and support correctional nurse wellbeing. TWEETABLE ABSTRACT A recent study found evidence for a relationship between organizational characteristics & job stress and U.S. correctional nurse wellbeing.
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Affiliation(s)
- Elizabeth G Keller
- University of Cincinnati, College of Nursing, Cincinnati, OH 45221, USA.
| | - Beverly M Hittle
- University of Cincinnati, College of Nursing, Cincinnati, OH 45221, USA
| | - Samantha Boch
- University of Cincinnati, College of Nursing, Cincinnati, OH 45221, USA; James M. Anderson Center for Health Systems Excellence, Cincinnati, OH 45229, USA
| | - Kermit Davis
- University of Cincinnati, College of Medicine, Cincinnati, OH 45267, USA
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Dugan AG, Decker RE, Zhang Y, Lombardi CM, Garza JL, Laguerre RA, Suleiman AO, Namazi S, Cavallari JM. Precarious Work Schedules and Sleep: A Study of Unionized Full-Time Workers. OCCUPATIONAL HEALTH SCIENCE 2022; 6:247-277. [PMID: 35372671 PMCID: PMC8962924 DOI: 10.1007/s41542-022-00114-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 02/22/2022] [Accepted: 03/03/2022] [Indexed: 11/28/2022]
Abstract
Unlike precarious employment which is temporary and insecure, with inadequate pay, benefits, and legal protections, precarious work schedules can affect workers with permanent full-time jobs in sectors where employment has historically been secure, well-compensated, and even unionized. Precarious work schedules - characterized by long shifts, non-daytime hours, intensity and unsocial work hours - are increasingly prevalent. Relations between precarious work schedules and poor health are not well understood, and less is known about how to attenuate this relation. We examined the indirect effects of precarious work schedules on fatigue and depressive symptoms through sleep quantity. Two moderators - schedule flexibility and sleep quality - were examined as buffers of these associations. Workers from the Departments of Correction and Transportation in a northeast state (N = 222) took surveys and reported on demographics, work schedule characteristics, schedule flexibility, sleep quality and quantity, fatigue, and depressive symptoms. Results revealed that precarious work schedules had indirect effects on fatigue and depressive symptoms through sleep quantity. Schedule flexibility moderated the relation between precarious work schedules and sleep quantity, such that workers with greater schedule flexibility had more hours of sleep. Sleep quality moderated the association between sleep quantity and fatigue and depressive symptoms, such that workers reported greater fatigue and depressive symptoms when they had poorer sleep quality. Findings have direct applicability for developing initiatives that enhance Total Worker Health® through individual and organizational changes. Supplementary Information The online version contains supplementary material available at 10.1007/s41542-022-00114-y.
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Affiliation(s)
- Alicia G Dugan
- Department of Medicine, Division of Occupational and Environmental Medicine, University of Connecticut School of Medicine, 263 Farmington Ave, Farmington, CT 06030 USA
| | - Ragan E Decker
- Society for Human Resource Management, 1800 Duke Street, Alexandria, VA 22314 USA
| | - Yuan Zhang
- Solomont School of Nursing, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, 113 Wilder Street, Lowell, MA 01854-5126 USA
| | - Caitlin M Lombardi
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Road, Unit 1058, Storrs, CT 06269 USA
| | - Jennifer L Garza
- Department of Medicine, Division of Occupational and Environmental Medicine, University of Connecticut School of Medicine, 263 Farmington Ave, Farmington, CT 06030 USA
| | - Rick A Laguerre
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT 06269 USA
| | - Adekemi O Suleiman
- Department of Public Health Sciences, University of Connecticut School of Medicine, 195 Farmington Ave, Farmington, CT 06030 USA
| | - Sara Namazi
- Department of Health Sciences, Springfield College, 468 Alden St, Springfield, MA 01109 USA
| | - Jennifer M Cavallari
- Department of Medicine, Division of Occupational and Environmental Medicine, University of Connecticut School of Medicine, 263 Farmington Ave, Farmington, CT 06030 USA.,Department of Public Health Sciences, University of Connecticut School of Medicine, 195 Farmington Ave, Farmington, CT 06030 USA
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