A moderated moderation analysis of perceived adaptivity and organizational support for innovation in the relationship between role overload and emotional exhaustion.

BACKGROUND: Collectively, an individual's ability and willingness to adjust to uncertain and complex changes in the workplace and an environment that supports employee problem-solving may facilitate individual-level adaptation to changes in the workplace and help mitigate the negative impact of work-related stressors on health care professionals' work-related behavior and mental health outcomes. PURPOSE: This study uses an interactionist perspective to assess how resources such as perceived adaptivity and organizational support for innovation serve as contextual boundary conditions of role overload in mitigating emotional exhaustion among health care workers. METHODOLOGY: A cross-sectional survey design was used to collect data from rural health care workers (n = 310). A moderated moderation analysis was performed to address the aims of the study. RESULTS: The results indicate that role overload has a significant positive effect on emotional exhaustion. Furthermore, a statistically significant three-way interaction effect of perceived adaptivity, organizational support for innovation, and role overload on emotional exhaustion was observed. Organizational support for innovation was found to mitigate the negative impact of role overload on emotional exhaustion for employees with high perceived adaptivity, but not for those with low perceived adaptivity levels. CONCLUSIONS: The findings from this study suggest that in high-stress work environments, integrating and appropriately matching personal and organizational resources could serve as a buffer against the effects of work stressors on emotional exhaustion. PRACTICAL IMPLICATIONS: Effective strategies to enhance employee emotional well-being may require the joint consideration of individual and organizational factors.

Examining Factors Associated With Minority Turnover Intention in State and Local Public Health Organizations: The Moderating Role of Race in the Relationship Among Supervisory Support, Job Satisfaction, and Turnover Intention.

CONTEXT: There is a need to understand minority governmental public health workforce turnover to ensure the retention of public health minority workers, capitalize on diversity benefits, and enhance public health's capacity to serve diverse populations. OBJECTIVE: This study assesses the moderating effect of minority health workers' race on (1) the relationship between the workforce environment, particularly employees' perceptions of their pay and supervisory support on job satisfaction, and (2) the relationship between job satisfaction and turnover intentions. DESIGN: Using the 2017 Public Health Workforce Interests and Needs Survey (PH WINS), a cross-sectional survey of the public health workforce, a hierarchical logistic regression modeling technique was used to assess the moderating role of race on the relationship between supervisory support, pay and job satisfaction, and turnover intentions. SETTING AND PARTICIPANTS: The PH WINS survey data from state and local health department employees. MAIN OUTCOME MEASURE: Job satisfaction, pay, supervisory support, and turnover intention. RESULTS: Job satisfaction was found to mediate the relationship between the work environment factors of pay satisfaction and supervisory support and turnover. Our findings also suggest that while race moderates the influence of compensation and supervisory support on job satisfaction, race has no moderating effect on the job satisfaction-turnover intentions relationship. CONCLUSIONS: A focus on boosting job satisfaction, particularly through pay equity and perceived support, may reduce turnover among minority public health personnel.

The impact of interpersonal support, supervisory support, and employee engagement on employee turnover intentions: Differences between financially distressed and highly financially distressed hospitals.

BACKGROUND: Critical access hospitals (CAHs) are small hospitals in rural communities in the United States. Because of changes in rural population demographics, legacy financial obligations, and/or structural issues in the U.S. health care system, many of these institutions are financially distressed. Indeed, many have closed due to their inability to maintain financial viability, resulting in a health care and economic crisis for their communities. Employee recruitment, retention, and turnover are critical to the performance of these hospitals. There is limited empirical study of the factors that influence turnover in such institutions. PURPOSE: The primary purpose of the study was to study relationships between interpersonal support, supervisory support, employee engagement, and employee turnover intentions in CAHs. A secondary purpose was to study how financial distress affects these relationships. METHODOLOGY: Based on a survey of CAH employees (n = 218), the article utilizes mediated moderation analysis of a structural equation model. RESULTS: Interpersonal support and supervisory support are positively associated with employee engagement, whereas employee engagement mediates the relationships between both interpersonal support and supervisory support and employee turnover intentions. Statistically significant differences are found between these relationships in financially distressed and highly financially distressed institutions. CONCLUSIONS: Our results are consistent with the social exchange theory upon which our hypotheses and model are built and demonstrate the value of using the degree of organizational financial distress as a contextual variable when studying motivational factors influencing employee turnover intentions. PRACTICAL IMPLICATIONS: In addition to advancing management theory as applied in the CAH context, our study presents the practical insight that employee perceptions of their employer's financial condition should be considered when organizations develop employee retention strategies. Specifically, employee engagement strategies appear to be of greater value in the case of highly financially distressed organizations, whereas supervisory support seems more effective in financially distressed organizations.

Screening for hepatitis B in the Bronx West African community with a blood pressure cuff: a cohort study.

Background: Hepatitis B (HBV) and hypertension (HTN) are prevalent in West Africa (WA). Inadequate control is common, and evaluation and management are challenging among immigrants due to unfamiliarity with the United States (US) healthcare system. While HBV is stigmatised, HTN is recognised as an important condition. We describe how a HTN screening program can facilitate HBV screening in the Bronx WA community. Methods: Thirty-minute HTN educational programs were delivered in collaboration with faith-based organisations, and 5-min presentations were presented upon request at community gatherings. Arrangements were made for those interested in a clinic visit where a questionnaire was completed, blood pressure (BP) measured, a free BP cuff provided, HBV testing performed, and referrals made. For those without ongoing care, insurance was arranged, and linkage to care provided. Findings: Seven 30-min and five 5-min presentations were conducted. After the 30-min presentation, 204 of 445 attendees (45.8%) requested a visit, and 68 (33.3%) attended the visit. After the 5-min presentation, 80 requested a visit and 51 (63.8%) attended the visit. A BP >140/90 mmHg was present in 122 individuals (48.4%), including 43 (17.1%) without a history of HTN and 39 (15.5%) with BP >160/90 mmHg. All except two who reported previous testing agreed to HBV testing. 19 (7.5%) were hepatitis B surface antigen positive. Transition into ongoing care was provided for 60 (33.9%) with HTN who were not integrated into the US healthcare system. Interpretation: HTN screening with a free BP cuff promotes HBV screening and US healthcare integration. Funding: No funding.