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Monsey LM, Beckman KL, Baker MG. How does gender and work location impact perceived worker stress during COVID-19? Findings from King County, WA. J Workplace Behav Health 2023; 38:75-101. [PMID: 37425094 PMCID: PMC10328059 DOI: 10.1080/15555240.2023.2166057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 01/04/2023] [Indexed: 01/13/2023]
Abstract
Using an online survey, we explored workplace determinants of perceived stress during COVID-19 in n=2910 county government workers, and differences in perceived stress by gender and work arrangement (work from home v. do not work from home). We explored relationships with descriptive statistics and linear regression. Access to health and safety resources, increased workplace safety climate, support for work-life balance, and increased access to sick leave were related to lower stress; dependent care stress and female gender were related to higher stress. Among those working from home, higher stress related to an increase in workload and erosion of work/life boundaries. Findings show how the workplace impacts stress, differential determinants by gender/work arrangement, and areas to intervene to improve employee health and well-being.
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Affiliation(s)
- Lily M. Monsey
- Department of Environmental & Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Kerry L. Beckman
- Department of Health Systems and Population Health, University of Washington, Seattle, WA, USA
| | - Marissa G. Baker
- Department of Environmental & Occupational Health Sciences, University of Washington, Seattle, WA, USA
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Beckman KL, Williams EC, Hebert P, Hawkins EJ, Littman AJ, Lehavot K. The impact of military sexual trauma and gender on receipt of evidence-based medication treatment among veterans with opioid use disorder. J Subst Abuse Treat 2022; 139:108775. [DOI: 10.1016/j.jsat.2022.108775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 02/25/2022] [Accepted: 03/15/2022] [Indexed: 10/18/2022]
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Beckman KL, Williams EC, Hebert PL, Frost MC, Rubinsky AD, Hawkins EJ, Littman AJ, Lehavot K. Associations Among Military Sexual Trauma, Opioid Use Disorder, and Gender. Am J Prev Med 2022; 62:377-386. [PMID: 34742619 DOI: 10.1016/j.amepre.2021.08.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 07/20/2021] [Accepted: 08/10/2021] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Opioid use disorder and high-risk opioid prescription increase the risks for overdose and death. In Veterans, military sexual trauma is associated with increased risk for assorted health conditions. This study evaluates the association of military sexual trauma with opioid use disorder and high-risk opioid prescription and potential moderation by gender. METHODS In a national sample of Veterans Health Administration outpatients receiving care from October 1, 2009 to August 1, 2017, logistic regression models were fit to evaluate the associations between military sexual trauma and opioid use disorder and high-risk opioid prescription, adjusting for demographic and clinical covariates. A second set of models included a gender X military sexual trauma interaction. Analyses were conducted in 2020-2021. RESULTS Patients with history of military sexual trauma (n=327,193) had 50% higher odds of opioid use disorder diagnosis (AOR=1.50, 95% CI=1.45, 1.54, p<0.001) and 5% higher odds of high-risk opioid prescription (AOR=1.05, 95% CI=1.04, 1.07, p<0.001) than those without history of military sexual trauma (n=7,738,665). The effect of military sexual trauma on opioid use disorder was stronger in men than in women . The predicted probability of opioid use disorder among men with history of military sexual trauma (1.5%) was nearly double that of women with history of military sexual trauma (0.8%). CONCLUSIONS Military sexual trauma was a significant risk factor for opioid use disorder and high-risk opioid prescription, with the former association particularly strong in men. Clinical care for Veterans with military sexual trauma should consider elevated risk of opioid use disorder and high-risk opioid prescription.
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Affiliation(s)
- Kerry L Beckman
- Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, Washington.
| | - Emily C Williams
- Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, Washington; COIN: Center of Innovation for Veteran-Centered and Value-Driven Care, Health Services Research & Development, VA Puget Sound Health Care System, U.S. Department of Veterans Affairs, Seattle, Washington
| | - Paul L Hebert
- Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, Washington; COIN: Center of Innovation for Veteran-Centered and Value-Driven Care, Health Services Research & Development, VA Puget Sound Health Care System, U.S. Department of Veterans Affairs, Seattle, Washington
| | - Madeline C Frost
- Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, Washington; COIN: Center of Innovation for Veteran-Centered and Value-Driven Care, Health Services Research & Development, VA Puget Sound Health Care System, U.S. Department of Veterans Affairs, Seattle, Washington
| | - Anna D Rubinsky
- COIN: Center of Innovation for Veteran-Centered and Value-Driven Care, Health Services Research & Development, VA Puget Sound Health Care System, U.S. Department of Veterans Affairs, Seattle, Washington; Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, California
| | - Eric J Hawkins
- COIN: Center of Innovation for Veteran-Centered and Value-Driven Care, Health Services Research & Development, VA Puget Sound Health Care System, U.S. Department of Veterans Affairs, Seattle, Washington; Center for Substance Addiction Treatment and Education, VA Puget Sound Health Care System, U.S. Department of Veterans Affairs, Seattle, Washington; Department of Psychiatry & Behavioral Sciences, School of Medicine, University of Washington, Seattle, Washington
| | - Alyson J Littman
- COIN: Center of Innovation for Veteran-Centered and Value-Driven Care, Health Services Research & Development, VA Puget Sound Health Care System, U.S. Department of Veterans Affairs, Seattle, Washington; Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington; Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, U.S. Department of Veterans Affairs, Seattle, Washington
| | - Keren Lehavot
- Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, Washington; COIN: Center of Innovation for Veteran-Centered and Value-Driven Care, Health Services Research & Development, VA Puget Sound Health Care System, U.S. Department of Veterans Affairs, Seattle, Washington; Department of Psychiatry & Behavioral Sciences, School of Medicine, University of Washington, Seattle, Washington
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Beckman KL, Monsey LM, Archer MM, Errett NA, Bostrom A, Baker MG. Health and safety risk perceptions and needs of app-based drivers during COVID-19. Am J Ind Med 2021; 64:941-951. [PMID: 34523153 PMCID: PMC8653178 DOI: 10.1002/ajim.23295] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 08/10/2021] [Accepted: 09/02/2021] [Indexed: 11/26/2022]
Abstract
Background App‐based drivers face work disruptions and infection risk during a pandemic due to the nature of their work, interactions with the public, and lack of workplace protections. Limited occupational health research has focused on their experiences. Methods We surveyed 100 app‐based drivers in Seattle, WA to assess risk perceptions, supports, and controls received from the company that employs them, sources of trust, stress, job satisfaction, COVID‐19 infection status, and how the pandemic had changed their work hours. Data were summarized descriptively and with simple regression models. We complemented this with qualitative interviews to better understand controls and policies enacted during COVID‐19, and barriers and facilitators to their implementation. Results Drivers expressed very high levels of concern for exposure and infection (86%–97% were “very concerned” for all scenarios). Only 31% of drivers reported receiving an appropriate mask from the company for which they drive. Stress (assessed via PSS‐4) was significantly higher in drivers who reported having had COVID‐19, and also significantly higher in respondents with lower reported job satisfaction. Informants frequently identified supports such as unemployment benefits and peer outreach among the driver community as ways to ensure that drivers could access available benefits during COVID‐19. Conclusions App‐based drivers received few protections from the company that employed them, and had high fear of exposure and infection at work. There is increased need for health‐supportive policies and protections for app‐based drivers. The most effective occupational and public health regulations would cover employees who may not have a traditional employer–employee relationship.
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Affiliation(s)
- Kerry L. Beckman
- Department of Health Systems and Population Health University of Washington School of Public Health Seattle Washington USA
| | - Lily M. Monsey
- Department of Environmental and Occupational Health Sciences University of Washington School of Public Health Seattle Washington USA
| | - Megan M. Archer
- Department of Environmental and Occupational Health Sciences University of Washington School of Public Health Seattle Washington USA
| | - Nicole A. Errett
- Department of Environmental and Occupational Health Sciences University of Washington School of Public Health Seattle Washington USA
| | - Ann Bostrom
- Evans School of Public Policy and Governance University of Washington Seattle Washington USA
| | - Marissa G. Baker
- Department of Environmental and Occupational Health Sciences University of Washington School of Public Health Seattle Washington USA
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Lehavot K, Beckman KL, Chen JA, Simpson TL, Williams EC. Race/Ethnicity and Sexual Orientation Disparities in Mental Health, Sexism, and Social Support among Women Veterans. Psychol Sex Orientat Gend Divers 2019; 6:347-358. [PMID: 31435497 PMCID: PMC6703561 DOI: 10.1037/sgd0000333] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVE To identify patterns of risk and resilience by the intersections of race/ethnicity and sexual orientation in mental health symptom severity, sexism, and social support among U.S. women veterans. METHODS A national sample of women veterans (n = 648, 38% sexual minority, 15% racial/ethnic minority) was recruited online in 2013 using social networking websites and listservs. Using cross-sectional survey data, we evaluated main and interactive associations between race/ethnicity and sexual orientation on depression, anxiety, posttraumatic stress, unhealthy alcohol use, sexism, and social support. Models were adjusted for other demographic characteristics. RESULTS Across depression, anxiety, and sexism, White heterosexual women reported the least distress and racial/ethnic minority heterosexual women the most distress (race/ethnicity x sexual orientation interactions p < .05). Among White women, sexual minority women reported greater levels of depression, anxiety, and sexism than heterosexual women. The effects were the opposite among racial/ethnic minority women, where heterosexual women reported similar or worse depression, anxiety, and sexism than sexual minority women. There were no race/ethnicity or sexual orientation interaction effects on posttraumatic stress symptoms or unhealthy alcohol use and marginally significant effects on social support. CONCLUSIONS Among women veterans, race/ethnicity and sexual orientation were associated with mental health and sexism, alone and in combination. Findings suggest that those who were both racial/ethnic and sexual minorities may develop resilience from their lived experience. On the other hand, women veterans with a minority race/ethnicity or a minority sexual orientation appeared more vulnerable to adverse outcomes and may need targeted care.
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Affiliation(s)
- Keren Lehavot
- Denver-Seattle Center of Innovation for Veteran-Centered Value-Driven Care, Health Services Research & Development, VA Puget Sound Health Care System
- Mental Illness Research, Education, and Clinical Center, VA Puget Sound Health Care System
- Department of Psychiatry and Behavioral Sciences, University of Washington
- Department of Health Services, University of Washington
| | | | - Jessica A. Chen
- Denver-Seattle Center of Innovation for Veteran-Centered Value-Driven Care, Health Services Research & Development, VA Puget Sound Health Care System
- Department of Health Services, University of Washington
| | - Tracy L. Simpson
- Mental Illness Research, Education, and Clinical Center, VA Puget Sound Health Care System
- Department of Psychiatry and Behavioral Sciences, University of Washington
- Center of Excellence in Substance Abuse Treatment and Education, VA Puget Sound Health Care System
| | - Emily C. Williams
- Denver-Seattle Center of Innovation for Veteran-Centered Value-Driven Care, Health Services Research & Development, VA Puget Sound Health Care System
- Department of Health Services, University of Washington
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Cohen EEW, LaMonte SJ, Erb NL, Beckman KL, Sadeghi N, Hutcheson KA, Stubblefield MD, Abbott DM, Fisher PS, Stein KD, Lyman GH, Pratt-Chapman ML. American Cancer Society Head and Neck Cancer Survivorship Care Guideline. CA Cancer J Clin 2016; 66:203-39. [PMID: 27002678 DOI: 10.3322/caac.21343] [Citation(s) in RCA: 363] [Impact Index Per Article: 45.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Answer questions and earn CME/CNE The American Cancer Society Head and Neck Cancer Survivorship Care Guideline was developed to assist primary care clinicians and other health practitioners with the care of head and neck cancer survivors, including monitoring for recurrence, screening for second primary cancers, assessment and management of long-term and late effects, health promotion, and care coordination. A systematic review of the literature was conducted using PubMed through April 2015, and a multidisciplinary expert workgroup with expertise in primary care, dentistry, surgical oncology, medical oncology, radiation oncology, clinical psychology, speech-language pathology, physical medicine and rehabilitation, the patient perspective, and nursing was assembled. While the guideline is based on a systematic review of the current literature, most evidence is not sufficient to warrant a strong recommendation. Therefore, recommendations should be viewed as consensus-based management strategies for assisting patients with physical and psychosocial effects of head and neck cancer and its treatment. CA Cancer J Clin 2016;66:203-239. © 2016 American Cancer Society.
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Affiliation(s)
- Ezra E W Cohen
- Medical Oncologist, Moores Cancer Center, University of California at San Diego, La Jolla, CA
| | - Samuel J LaMonte
- Retired Head and Neck Surgeon, Former Associate Professor of Otolaryngology and Head and Neck Surgery, Louisiana State University Health and Science Center, New Orleans, LA
| | - Nicole L Erb
- Program Manager, National Cancer Survivorship Resource Center, American Cancer Society, Atlanta, GA
| | - Kerry L Beckman
- Research Analyst-Survivorship, American Cancer Society, Atlanta, GA
| | - Nader Sadeghi
- Professor of Surgery, Division of Otolaryngology-Head and Neck Cancer Surgery, and Director of Head and Neck Surgical Oncology, George Washington University, Washington, DC
| | - Katherine A Hutcheson
- Associate Professor, Department of Head and Neck Surgery, Section of Speech Pathology and Audiology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Michael D Stubblefield
- Medical Director for Cancer Rehabilitation, Kessler Institute for Rehabilitation, West Orange, NJ
| | - Dennis M Abbott
- Chief Executive Officer, Dental Oncology Professionals, Garland, TX
| | - Penelope S Fisher
- Clinical Instructor of Otolaryngology and Nurse, Miller School of Medicine, Department of Otolaryngology, Division of Head and Neck Surgery, University of Miami, Miami, FL
| | - Kevin D Stein
- Vice President, Behavioral Research, and Director, Behavioral Research Center, American Cancer Society, Atlanta, GA
| | - Gary H Lyman
- Co-Director, Hutchinson Institute for Cancer Outcomes Research, Fred Hutchinson Cancer Research Center, and Professor of Medicine, University of Washington School of Medicine, Seattle, WA
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