Work stressors, work-family conflict, parents' depressive symptoms and perceived parental concern for their children's mental health during COVID-19 in Canada: a cross-sectional analysis.

BACKGROUND: Work-related stressors and work-family conflict are important social determinants of mental health. While the impact of these stressors on parents' mental health is well documented, we know comparatively less about their impact on children's mental health. Furthermore, though the COVID-19 pandemic has significantly altered these stressors, particularly with the increase in teleworking, major knowledge gaps persist regarding the association between parents' stressors and perceived parental concern for their children's mental health during the COVID-19 pandemic. Based on the stress contagion perspective, this study tests (1) the mediating role of parents' depressive symptoms with parental concern for their children's mental health, and (2) whether these associations vary depending on whether parents had the opportunity to engage in telework. METHODS: A path analysis was performed from a cross-sectional analytic sample of 780 employed parents in the province of Quebec (Canada). The same model was then stratified by teleworking opportunity. The model's indirect associations were obtained by the bootstrap bias-corrected method with 1,000 replications. RESULTS: The results show that the stressors of work-to-family conflict, increased difficulties in work-family balance since the COVID-19 pandemic, irregular schedules, low esteem derived from work, and job insecurity were all indirectly associated with an increase in parental concern for their children's mental health through increased parents' depressive symptoms. However, some associations differ depending on teleworking status. The indirect associations involving increased difficulties in work-family balance since the COVID-19 pandemic as well as irregular work schedules were observed only in the teleworking group. CONCLUSIONS: This study fills a gap in research on the association between the work-family interface and parental concern for their children's mental health during the COVID-19 pandemic. It highlights the importance of concerted and cohesive action between child health policies and those regarding work and work-family balance to prevent work-related psychosocial risks, particularly considering the post pandemic expanded and persistent reliance on teleworking.

Work-family interface and children's mental health: a systematic review.

The COVID-19 pandemic and the public health measures adopted to contain it have highlighted the centrality of the work-family interface in the etiology of mental health among the employed population. However, while the impact on the mental health of workers has been well documented, the relationship with the mental health of children of those workers remains to be clarified.A systematic review was conducted through the identification of peer-reviewed studies on the association between parental work-family interface (e.g. work-family conflict and/or work-family enrichment) and children's mental health. This method is based on the consultation of 7 databases (MEDLINE, PubMed, Web of Science, PsycINFO, SocIndex, Embase, and Scopus), considering all studies published through June 2022 (PROSPERO: CRD42022336058). Methodology and findings are reported according to the PRISMA guidelines. 25 of the 4146 identified studies met our inclusion criteria. Quality appraisal was performed using a modified Newcastle-Ottawa scale. Most studies investigated only work-family conflict, ignoring work-family enrichment. Child mental health outcomes evaluated included internalizing behaviours (n = 11), externalizing behaviours (n = 10), overall mental health (n = 13), and problematic Internet usage (n = 1). Results of the review are summarized qualitatively. Our analysis shows equivocal evidence for the direct relationships between the work-family interface and children's mental health, as a large proportion of associations did not reach statistical significance. We can, however, posit that work-family conflict seems to be more associated with children's mental health problems while work-family enrichment was more related to children's positive mental health. A greater proportion of significant associations are observed for internalizing behaviors compared to externalizing behaviors. Almost all the studies that test for a mediating effect found that parental characteristics and parental mental health are significant mediators.Our research provides insight into the complex association between work-family interface and child mental health, showing both beneficial and detrimental consequences that may even occur simultaneously. This highlights the far-reaching effects of contexts affecting the work-family interface, including the COVID-19 pandemic. We conclude with the need for research adopting more standardized and nuanced measures of the work-family interface to further validate these conclusions.

Gender, work-family conflict and depressive symptoms during the COVID-19 pandemic among Quebec graduate students.

The increasing mental health inequalities between women and men following the COVID-19 crisis represent a major public health concern. Public health measures to mitigate the pandemic could severely impact populations with high prevalence of mental health problems such as graduate students. We aimed to document the gendered experience of the lockdown and its association with depressive symptoms among graduate students in Quebec. We contrast two hypotheses: whether inequalities in depressive symptoms between women and men could be linked to their differential exposure or vulnerability to work, family and study conditions, with the mediating role of work-to-family interference (WIF) and family-to-work interference (FIW). This observational study used path analysis to test our hypotheses using a cross-sectional data collected from 1,790 graduate students from three universities in Quebec. The exposure hypothesis received more support. Women reported more stress regarding new teaching methods, which was associated directly with more depressive symptoms, and indirectly through WIF. Women were more worried about COVID-19, which was associated with more depressive symptoms, and indirectly through WIF and FIW. However, women reported less FIW and more emotional support, both respectively associated with less depressive symptoms. The policy measures taken after the COVID-19 were not gender-neutral. This study demonstrates the importance of taking the potentially gendered effects of policies into consideration, and points to mitigating actions that can forestall the exacerbation of gendered inequalities in mental health.

Psychological distress inequality between employed men and women: A gendered exposure model.

This study examines an exposure model in which the work and family stressors and the access to resources are gendered and contribute to explaining the psychological distress inequality between sex categories, both directly and indirectly through work-family conflict. A multilevel path analysis conducted on a random cross-sectional sample of 2026 Canadians workers from 63 establishments was performed. Our exposure model fully explains the higher level of psychological distress among working women compared to working men. Women are more exposed to work-to-family conflict, have less decision authority, are more likely to be a single parent and have less self-esteem, factors that are directly associated with a higher level of psychological distress. On the other hand, women work fewer hours, have less irregular or evening schedules and have more social resources outside of work, which contribute to lower their level of psychological distress through less work-to-family conflict. By identifying which of the differences in exposure to work and family stressors and resources explain the greater psychological distress of working women compared to working men, and by examining the mediating role of work-family conflict in this process, this study identified specific paths to reduce psychological distress inequality between women and men in the workplace.

Work, family, work-family conflict and psychological distress: A revisited look at the gendered vulnerability pathways.

This paper revisited the vulnerability hypothesis to explain the greater level of psychological distress among working women compared to working men. A comprehensive vulnerability model was tested in which work and family stressors and psychosocial resources are directly related to psychological distress and indirectly through work-to-family (WFC) and family-to-work (FWC) conflicts. Data came from a random sample of 989 women and 1,037 men working in 63 Canadian establishments. Multilevel path analyses were performed separately for men and for women. The results show that many work/family stressors and resources are linked to men's or women's psychological distress directly and indirectly through WFC and FWC. However, the z-test used to assess whether the relationships differed significantly between women and men indicated that only two relationships differ significantly between the two groups: experimenting problems with children and a low self-esteem are associated positively to psychological distress through FWC only for women. In addition to showing the specific involvement of work-family conflict in the psychological distress inequality, this study contributes to revealing that testing the differences in the magnitude of the relation offer a more suitable appraisal of the vulnerability mechanism involved in the psychological distress inequality between men and women.

Emergency Department-initiated Interventions for Patients With Opioid Use Disorder: A Systematic Review.

OBJECTIVES: The opioid crisis has risen dramatically in North America in the new millennium, due to both illegal and prescription opioid use. While emergency departments (EDs) represent a potentially strategic setting for interventions to reduce harm from opioid use disorder (OUD), the absence of a recent synthesis of literature limits implementation and scalability. To fill this gap, we conducted a systematic review of the literature on interventions targeting OUDs initiated in EDs. METHODS: Using an explicit search strategy (PROSPERO), the MEDLINE, CINAHL Complete, EMBASE, and EBM reviews databases were searched from 1980 to October 4, 2019. The gray literature was explored using Google Scholar. Study characteristics were abstracted independently. The methodologic quality and risk of bias were assessed. RESULTS: Twelve of 2,270 studies met the inclusion criteria (two of high quality). In addition to the heterogeneity of the outcome measures used (retention in treatment, opioid consumption, and overdose), brief intervention and buprenorphine initiation (six of 12 studies) were the most documented with mixed effects for the former and positive short-term and confined to single ED sites effects for the latter. CONCLUSION: Emergency departments can be an appropriate setting for initiating opioid agonist treatment, but to be sustained, it likely needs to be coupled with community-based follow-up and support to ensure longer-term retention. The scarcity of high-quality evidence on OUD interventions initiated in emergency settings highlights the need for future research.

Gendered Pathways to Burnout: Results from the SALVEO Study.

Aim: Burnout is a pervasive mental health problem in the workforce, with mounting evidence suggesting ties with occupational and safety outcomes such as work injuries, critical events and musculoskeletal disorders. While environmental [work and non-work, work-to-family conflict (WFC)] and individual (personality) pathways to burnout are well documented, little is known about how gender comes to influence such associative patterns. The aim of the study consisted in examining gendered pathways to burnout. Methods: Data were derived from the SALVEO study, a cross-sectional study of 2026 workers from 63 workplaces from the province of Québec (Canada). Data were analyzed using multilevel path analysis. Results: Direct effects of gendered pathways were evidenced for work (e.g. decision latitude) and non-work (e.g. child-related strains) environmental pathways, as well as for individual pathways (i.e. internal locus of control). Indirect effects of gendered pathways were also evidenced, with women reporting higher levels of burnout compared to men due to lower levels of decision latitude and of self-esteem, as well as higher levels of WFC. Women also reported lower burnout levels through investing more time into domestic tasks, which could represent a recovery strategy to highly demanding work. WFC further mediated the associations between working hours and burnout, as well as the between irregular work schedules and burnout. These result suggest than men distinctively reported higher levels of burnout due to the specific nature of their work contract negatively impacting on WFC, and incidentally, on their mental health. Conclusion: Study results supported our hypotheses positing that gender distinctively shapes environmental and individual pathways to burnout. OHS prevention efforts striving for better mental health outcomes in the workforce could relevantly be informed by a gendered approach to burnout.

Gendered depression: Vulnerability or exposure to work and family stressors?

OBJECTIVE: Research has shown that employed women are more prone to depression than men, but the pathways linking gender to depression remain poorly understood. The aim of this study was to examine how work and family conditions operated as potentially gendered antecedents of depression. It evaluated more specifically how differences in depressive symptoms in women and men could be explained by their differential vulnerability and exposure to work and family conditions, as well as by the mediating role of work-to-family conflict (WFC) and family-to-work conflict (FWC). METHODS: Data were collected in 2009-2012 from a sample of 1935 employees (48.9% women) nested in 63 workplaces in the province of Quebec (Canada). Data were analyzed with multilevel path analysis models to test for the differential exposure hypothesis, and stratified by gender to test for the differential vulnerability hypothesis. RESULTS: Results supported both hypothesizes, but only WFC played a mediating role between work-family stressors and depression. Regarding the vulnerability hypothesis, WFC was more strongly associated with women depressive symptoms, and the magnitude of the association between family income and WFC was stronger for women. Overall, the differential exposure hypothesis seemed to reach a greater empirical support. After accounting for work and family stressors as well as WFC, differences in depressive symptoms in women and men were no longer significantly, as WFC, working hours, irregular work schedule and skill utilization acted as mediators. WFC associated with higher depressive symptoms and skill utilization with lower depressive symptoms. WFC related to higher working hours and irregular work schedule. Compared to men, women reported higher WFC, but lower working hours, less irregular work schedule and lower skill utilization at work. CONCLUSION: Women's higher rate of depression is intrinsically linked to their different social experiences as shaped by a gendered social structure and gendered organizations.