Considering the Differential Impact of Three Facets of Organizational Health Climate on Employees' Well-Being.

One potential way that healthy organizations can impact employee health is by promoting a climate for health within the organization. Using a definition of health climate that includes support for health from multiple levels within the organization, this study examines whether all three facets of health climate--the workgroup, supervisor, and organization--work together to contribute to employee well-being. Two samples are used in this study to examine health climate at the individual level and group level in order to provide a clearer picture of the impact of the three health climate facets. k-means cluster analysis was used on each sample to determine groups of individuals based on their levels of the three health climate facets. A discriminant function analysis was then run on each sample to determine if clusters differed on a function of employee well-being variables. Results provide evidence that having strength in all three of the facets is the most beneficial in terms of employee well-being at work. Findings from this study suggest that organizations must consider how health is treated within workgroups, how supervisors support employee health, and what the organization does to support employee health when promoting employee health.

Lower-extremity joint kinematics and muscle activations during semi-reclined cycling at different workloads in healthy individuals.

BACKGROUND: A better understanding of lower-extremity muscles' activation patterns and joint kinematics during different workloads could help rehabilitation professionals with prescribing more effective exercise regimen for elderly and those with compromised muscles. We examined the relative contribution, as well as activation and co-activation patterns, of lower-extremity muscles during semi-reclined cycling at different workloads during a constant cadence. METHODS: Fifteen healthy novice cyclists participated at three 90-second cycling trials with randomly assigned workloads of 0, 50, and 100 W, at a constant cadence of 60 rpm. During all trials, electromyograms were recorded from four lower-extremity muscles: rectus femoris (RF), biceps femoris (BF), tibialis anterior (TA), and gastrocnemius medialis (GT). Joint kinematics were also recorded and synchronized with the EMG data. Muscle burst onset, offset, duration of activity, peak magnitude, and peak timing, as well as mean joint angles and mean ranges of motion were extracted from the recorded data and compared across workloads. RESULTS: As workload increased, BF and TA displayed earlier activations and delayed deactivations in each cycle that resulted in a significantly (p < 0.05) longer duration of activity at higher workloads. RF showed a significantly longer duration of activity between 0 and 50 W as well as 0 and 100 W (p < 0.05); however, the activity duration of GT was not appeared to be affected significantly by workload. EMG peak-magnitude of RF, BF, and TA changed significantly (p < 0.05) as workload increased, but no changes were observed in the EMG peak-timing across workloads. Durations of co-activation in the RF-BF pair as well as the RF-TA pair increased significantly with workload, while the RF-TA and TA-GT pairs were only significantly different (p < 0.05) between the 0 and 100 W workload levels. Increased workload did not lead to any significant changes in the joint kinematics. CONCLUSIONS: Muscles' activity patterns as well as co-activation patterns are significantly affected by changes in cycling workloads in healthy individuals. These variations should be considered during cycling, especially in the elderly and those with compromised musculoskeletal systems. Future research should evaluate such changes specific to these populations.

The Healthy Work Survey: A Standardized Questionnaire for the Assessment of Workplace Psychosocial Hazards and Work Organization in the United States.

OBJECTIVES: Work-related psychosocial stressors have been recognized as occupational hazards and assessed in workplaces in many countries for decades. Identifying tools to measure work-related psychosocial hazards to increase awareness in the United States about the impact on employees' health and safety is critical ( J Occup Environ Med. 2021;63:e245-e249). METHODS: We describe the development and psychometric validation of an online tool, the Healthy Work Survey, utilizing items from the National Institute for Occupational Safety and Health Quality of Work Life questionnaire. RESULTS: There are 55 items in the final core work section of the HWS. Factor analyses confirmed nine factors, and the subsequent multi-item scales had acceptable internal consistency. A user-friendly, online system and automated report compares individual's and organization's scores to distributions from a representative US working population (General Social Survey Quality of Work Life). DISCUSSION: The HWS is a reliable, valid tool for organizations and individuals to assess psychosocial work hazards.

A Simple Liking Survey Captures Behaviors Associated with Weight Loss in a Worksite Program among Women at Risk of Type 2 Diabetes.

In a secondary analysis, we assessed the ability of dietary and physical activity surveys to explain variability in weight loss within a worksite-adapted Diabetes Prevention Program. The program involved 58 overweight/obese female employees (average age = 46 ± 11 years SD; average body mass index = 34.7 ± 7.0 kg/m2 SD) of four long-term care facilities who survey-reported liking and frequency of dietary and physical activity behaviors. Data were analyzed using a latent variable approach, analysis of covariance, and nested regression analysis to predict percent weight change from baseline to intervention end at week 16 (average loss = 3.0%; range-6% gain to 17% loss), and follow-up at week 28 (average loss = 2.0%; range-8% gain to 16% loss). Using baseline responses, restrained eaters (reporting liking but low intakes of high fat/sweets) achieved greater weight loss at 28 weeks than those reporting high liking/high intake (average loss = 3.5 ± 0.9% versus 1.0 ± 0.8% S.E., respectively). Examining the dietary surveys separately, only improvements in liking for a healthy diet were associated significantly with weight loss (predicting 44% of total variance, p < 0.001). By contrasting liking versus intake changes, women reporting concurrent healthier diet liking and healthier intake lost the most weight (average loss = 5.4 ± 1.1% S.E.); those reporting eating healthier but not healthier diet liking (possible misreporting) gained weight (average gain = 0.3 ± 1.4% S.E.). Change in liking and frequency of physical activity were highly correlated but neither predicted weight loss independently. These pilot data support surveying dietary likes/dislikes as a useful measure to capture dietary behaviors associated with weight loss in worksite-based programs. Comparing dietary likes and intake may identify behaviors consistent (appropriate dietary restraint) or inconsistent (misreporting) with weight loss success.

The living arrangement may differentially influence IDU parents' motivation to reduce HIV risk as a function of gender.

Studies that examine data from drug-abusing parents typically investigate the impact of parental behavior on their children's well-being and focus almost exclusively on the impact of mothers. Other approaches have examined the level of parental involvement among parents in drug treatment and find that a higher level of parental involvement is related to lower levels of addiction severity. Recent research examines the specific role of fathers and suggests that the promotion of responsible parenting may serve as a positive motivational influence among fathers participating in drug treatment. The present study investigated the influence of the living arrangement on improvements in HIV-risk reduction variables among 151 IDU parents who participated in the Community-friendly Health Recovery Program intervention. A gender×living arrangement interaction demonstrated greater enhancements in social and personal motivation to reduce HIV risk among fathers currently living with their children vs. fathers not living with their children while the opposite pattern of outcomes was demonstrated for mothers. Findings indicate that a parenting role that includes living with children may differentially influence parents' HIV-risk reduction motivation as a function of gender.

A conceptual framework for integrating workplace health promotion and occupational ergonomics programs.

Musculoskeletal, cardiovascular, and mental health are all associated with the physical and psychosocial conditions of work, as well as with individual health behaviors. An integrated approach to workplace health-promotion programs should include attention to the work environment, especially in light of recent findings that work organization influences so-called lifestyle or health behaviors. Macroergonomics provides a framework to improve both physical and organizational features of work and, in the process, to empower individual workers. The Center for the Promotion of Health in the New England Workplace (CPH-NEW) is a research-to-practice effort examining the effectiveness of worksite programs that combine occupational safety and health--especially ergonomics--with health promotion, emphasizing the contribution of work organization to both. Two intervention studies are underway in three different sectors: health care, corrections, and manufacturing. Each study features participatory structures to facilitate employee input into health goal-setting, program design and development, and evaluation, with the goal of enhanced effectiveness and longer-term sustainability.

Workplace health protection and promotion through participatory ergonomics: an integrated approach.

A multidisciplinary team of researchers at the Center for the Promotion of Health in the New England Workplace (CPH-NEW) developed an evidence-based approach to address three recognized challenges to workplace programs designed to improve employee health: establishing employee ownership, integrating with work organization, and sustainability. The two main innovations being introduced in combination were (1) integrating traditional workplace health protection (e.g., ergonomics, industrial hygiene) with health promotion (e.g., assisting workers in improving health behaviors) and (2) introducing a bottom-up participatory model for engaging employees in innovative iterative design efforts to enhance both components of this integrated program. In the program, which was modeled after participatory ergonomics programs, teams of workers engage in the iterative design of workplace interventions to address their prioritized health concerns with the support of a multilevel steering committee. The integrated approach being tested can complement existing worksite safety and health initiatives and promote organizational learning, with expected synergistic effects.

Leg joint power output during progressive resistance FES-LCE cycling in SCI subjects: developing an index of fatigue.

BACKGROUND: The purpose of this study was to investigate the biomechanics of the hip, knee and ankle during a progressive resistance cycling protocol in an effort to detect and measure the presence of muscle fatigue. It was hypothesized that knee power output can be used as an indicator of fatigue in order to assess the cycling performance of SCI subjects. METHODS: Six spinal cord injured subjects (2 incomplete, 4 complete) between the ages of twenty and fifty years old and possessing either a complete or incomplete spinal cord injury at or below the fourth cervical vertebra participated in this study. Kinematic data and pedal forces were recorded during cycling at increasing levels of resistance. Ankle, knee and hip power outputs and resultant pedal force were calculated. Ergometer cadence and muscle stimulation intensity were also recorded. RESULTS: The main findings of this study were: (a) ankle and knee power outputs decreased, whereas hip power output increased with increasing resistance, (b) cadence, stimulation intensity and resultant pedal force in that combined order were significant predictors of knee power output and (c) knowing the value of these combined predictors at 10 rpm, an index of fatigue can be developed, quantitatively expressing the power capacity of the knee joint with respect to a baseline power level defined as fatigue. CONCLUSION: An index of fatigue was successfully developed, proportionalizing knee power capacity during cycling to a predetermined value of fatigue. The fatigue index value at 0/8th kp, measured 90 seconds into active, unassisted pedaling was 1.6. This indicates initial power capacity at the knee to be 1.6 times greater than fatigue. The fatigue index decreased to 1.1 at 2/8th kp, representing approximately a 30% decrease in the knee's power capacity within a 4 minute timespan. These findings suggest that the present cycling protocol is not sufficient for a rider to gain the benefits of FES and thus raises speculation as to whether or not progressive resistance cycling is an appropriate protocol for SCI subjects.

Functional electrical stimulation-induced muscular fatigue: Effect of fiber composition and stimulation frequency on rate of fatigue development.

This investigation evaluated the progression towards fatigue in two muscles of differing fast- and slow-twitch fiber proportions (abductor pollicis brevis (APB) and vastus lateralis (VL)) when activated by functional electrical stimulation (FES) at three frequencies (10, 35, and 50 Hz). Fatigue was defined as a 50% drop from the initial FES-induced force of 25% maximal voluntary contraction (MVC). Ten healthy adults (mean age: 23.2 ±â€¯3.0 years) were recruited; participants signed an IRB approved consent form prior to participation. Protocols were developed to evaluate the effects of muscle size, fiber type and FES frequency on total time to fatigue. Results indicated that the predominantly fast-twitch VL fatigued more quickly than the slow-twitch APB at the higher frequencies (p < 0.05), but did not significantly differ with stimulation at 10 Hz. Overall, muscle size and FES frequencies showed some significant interactions when generating a defined force and during fatigue development. Furthermore, it appears that to reduce fatigue, FES treatments should not extend past ∼14-16 min for large and small muscle groups, respectively, when the muscle group's optimal stimulation frequency is applied.

Electrical Stimulation Frequency and Skeletal Muscle Characteristics: Effects on Force and Fatigue.

This investigation aimed to determine the force and muscle surface electromyography (EMG) responses to different frequencies of electrical stimulation (ES) in two groups of muscles with different size and fiber composition (fast- and slow-twitch fiber proportions) during a fatigue-inducing protocol. Progression towards fatigue was evaluated in the abductor pollicis brevis (APB) and vastus lateralis (VL) when activated by ES at three frequencies (10, 35, and 50Hz). Ten healthy adults (mean age: 23.2 ± 3.0 years) were recruited; participants signed an IRB approved consent form prior to participation. Protocols were developed to 1) identify initial ES current intensity required to generate the 25% maximal voluntary contraction (MVC) at each ES frequency and 2) evaluate changes in force and EMG activity during ES-induced contraction at each frequency while progressing towards fatigue. For both muscles, stimulation at 10Hz required higher current intensity of ES to generate the initial force. There was a significant decline in force in response to ES-induced fatigue for all frequencies and for both muscles (p<0.05). However, the EMG response was not consistent between muscles. During the progression towards fatigue, the APB displayed an initial drop in force followed by an increase in EMG activity and the VL displayed a decrease in EMG activity for all frequencies. Overall, it appeared that there were some significant interactions between muscle size and fiber composition during progression towards fatigue for different ES frequencies. It could be postulated that muscle characteristics (size and fiber composition) should be considered when evaluating progression towards fatigue as EMG and force responses are not consistent between muscles.

Perceived Self-Efficacy and Financial Incentives: Factors Affecting Health Behaviors and Weight Loss in a Workplace Weight Loss Intervention.

OBJECTIVE: To evaluate if self-efficacy (SE) and financial incentives (FI) mediate the effect of health behavior on weight loss in a group of overweight and obese nursing-home employees participating in a 16-week weight-loss intervention with 12-week follow-up. METHODS: Ninety nine overweight/obese (body mass index [BMI] > 25) employees from four nursing-homes participated, with a mean age of 46.98 years and BMI of 35.33. Nursing-homes were randomized to receiving an incentive-based intervention (n = 51) and no incentive (n = 48). Participants' health behaviors and eating and exercise self-efficacy (Ex-SE) were assessed at week 1, 16, and 28 using a self-reported questionnaire. Mediation and moderated mediation analysis assessed relationships among these variables. RESULTS: Eating self-efficacy (Eat-SE) and Ex-SE were significant mediators between health behaviors and weight loss (P < 0.05). Incentives significantly moderated the effects of self-efficacy (P = 0.00) on weight loss. CONCLUSIONS: Self-efficacy and FI may affect weight loss and play a role in weight-loss interventions.

Associations Among Work and Family Health Climate, Health Behaviors, Work Schedule, and Body Weight.

OBJECTIVES: Correctional employees exhibit elevated obesity rates. This study examines interrelations among health behaviors, health climate, body mass index (BMI), and work schedule. METHODS: Using survey results from correctional supervisors (n = 157), mediation and moderated-mediation analyses were performed to examine how health behaviors explain relationships between obesity, work health climate (WHC) and family health climate (FHC), and work schedule. RESULTS: Over 85% of the sample was overweight/obese (mean BMI = 30.20). Higher WHC and FHC were associated with lower BMI, mediated by nutrition, and physical activity. The interaction effect between health behavior and work schedule revealed a protective effect on BMI. Overtime shift work may share a relationship with BMI. CONCLUSIONS: Findings may have implications for reexamining organizational policies on maximum weekly overtime in corrections. They provide direction for targeted obesity interventions that encourage a supportive FHC and promote healthy behaviors among supervisors working overtime.

Prediction of calf volume during muscle contraction.

This study evaluated the relationship between calf volume changes and different intensities of maximum voluntary contractions (MVCs) of a lower limb performing plantar flexions. An electronic plethysmography instrument (EPI) was developed, and after testing for its reliability, it was used to measure calf volume changes. For EPI, the reliability correlation coefficients (r) to measure calf volume consistently were .98, .91, and .98 at 100% MVC, 80% MVC, and 60% MVC, respectively. There were also significant correlations between calf volume changes and the different intensities of MVC (MVC: r = .42, p < .011; 80% MVC: r = .41, p < .013; 60% MVC: r = .5, p < .002). The calf volume changes at different levels of muscle contractions also correlate significantly (upper calf: r = .55, p < .0002; middle calf: r = .58, p < .0007; and lower calf: r = .55, p < .002). The results indicated that EPI might be used as a reliable tool to predict the intensity of muscle contraction based on calf volume changes. Clinicians who use functional electrical stimulation to induce muscle contraction in people with muscle paralysis may use EPI to predict the volume changes during functional electrical stimulation-induced contractions and to deliver the proper amount of electrical stimulation, producing the desired level of contraction without undue stimulation or fatigue.

Electrically and Hybrid-Induced Muscle Activations: Effects of Muscle Size and Fiber Type.

The effect of three electrical stimulation (ES) frequencies (10, 35, and 50 Hz) on two muscle groups with different proportions of fast and slow twitch fibers (abductor pollicis brevis (APB) and vastus lateralis (VL)) was explored. We evaluated the acute muscles' responses individually and during hybrid activations (ES superimposed by voluntary activations). Surface electromyography (sEMG) and force measurements were evaluated as outcomes. Ten healthy adults (mean age: 24.4 ± 2.5 years) participated after signing an informed consent form approved by the university Institutional Review Board. Protocols were developed to: 1) compare EMG activities during each frequency for each muscle when generating 25% Maximum Voluntary Contraction (MVC) force, and 2) compare EMG activities during each frequency when additional voluntary activation was superimposed over ES-induced 25% MVC to reach 50% and 75% MVC. Empirical mode decomposition (EMD) was utilized to separate ES artifacts from voluntary muscle activation. For both muscles, higher stimulation frequency (35 and 50Hz) induced higher electrical output detected at 25% of MVC, suggesting more recruitment with higher frequencies. Hybrid activation generated proportionally less electrical activity than ES alone. ES and voluntary activations appear to generate two different modes of muscle recruitment. ES may provoke muscle strength by activating more fatiguing fast acting fibers, but voluntary activation elicits more muscle coordination. Therefore, during the hybrid activation, less electrical activity may be detected due to recruitment of more fatigue-resistant deeper muscle fibers, not reachable by surface EMG.

The weight loss blogosphere: an online survey of weight loss bloggers.

Blogging is a form of online journaling that has been increasingly used to document an attempt in weight loss. Despite the prevalence of weight loss bloggers, few studies have examined this population. We examined characteristics of weight loss bloggers and their blogs, including blogging habits, reasons for blogging, like and dislikes of blogging, and associations between blogging activity and weight loss. Participants (N = 194, 92.3 % female, mean age = 35) were recruited from Twitter and Facebook to complete an online survey. Participants reported an average weight loss of 42.3 pounds since starting to blog about their weight loss attempt. Blogging duration significantly predicted greater weight loss during blogging (ß = -3.65, t(185) = -2.97, p = .003). Findings suggest that bloggers are generally successful with their weight loss attempt. Future research should explore what determines weight loss success/failure in bloggers and whether individuals desiring to lose weight would benefit from blogging.

Work Characteristics as Predictors of Correctional Supervisors' Health Outcomes.

OBJECTIVE: This study examined associations among health behaviors, psychosocial work factors, and health status. METHODS: Correctional supervisors (n = 157) completed a survey that assessed interpersonal and organizational views on health. Chi-square and logistic regressions were used to examine relationships among variables. RESULTS: Respondents had a higher prevalence of obesity and comorbidities compared with the general US adult population. Burnout was significantly associated with nutrition, physical activity, sleep duration, sleep quality, diabetes, and anxiety/depression. Job meaning, job satisfaction, and workplace social support may predict health behaviors and outcomes. CONCLUSIONS: Correctional supervisors are understudied and have poor overall health status. Improving health behaviors of middle-management employees may have a beneficial effect on the health of the entire workforce. This paper demonstrates the importance of psychosocial work factors that may contribute to health behaviors and outcomes.

Health Behavior Knowledge and Self-efficacy as Predictors of Body Weight.

Obesity is a public health concern with significant economic costs affecting employers. Worksite wellness programs benefit from developing tailored interventions that consider employees' health-related knowledge and self-efficacy to change behavior. Correction is a high stress occupation with elevated rates of overweight and obesity. Poor stress management and barriers to achieve optimal health in the work environment increases the need for adequate knowledge and self-efficacy, or the level of confidence to eat healthy and be physically active. This cross-sectional pilot study used a sample of sixteen correctional employees who participated in a Nutrition and Physical Activity Questionnaire. This survey assesses knowledge and self-efficacy for nutrition and physical activity and current health behaviors, such as current dietary habits and level of physical activity. Demographic and anthropometric data were also collected for statistical analyses. Participants were primarily male correction officers working first shift with a mean (±SE) BMI of 29 (±1.05) kg/m2, classified as overweight. Multiple regression analyses revealed that knowledge and self-efficacy scores predicted variation in BMI when controlling for other scores in the model. Findings from this study may be applicable for future health promotion interventions in high-risk occupations. In high-risk occupations such as corrections, understanding environmental and organizational barriers to achieving good health and reducing chronic disease risk is important. However, in addition to reducing these barriers, increasing knowledge, improving skills and self-efficacy to achieve good health are also critical in order to develop effective interventions for this population.

The Link between Musculoskeletal Pain, Lifestyle Behaviors, Exercise Self-Efficacy, and Quality of Life in Overweight and Obese Individuals.

OBJECTIVE: To determine the extent musculoskeletal (MS) pain in the low back and knee (weight-bearing (WB) joints), shoulder and wrist (non-weight bearing joints), and exercise self-efficacy mediates associations between overweight and obesity levels based on BMI (4 levels: overweight, obese class I, II, or III), physical function, emotional role, social interference, and physical activity (PA) levels. DESIGN: Cross-sectional study. SETTING: Four long-term nursing home facilities in the Northeast U.S. PARTICIPANTS: 99 overweight or obese (BMI > 25) nursing home employees. INTERVENTIONS: Self-reported survey administered to employees who met inclusion and exclusion criteria. MAIN OUTCOME MEASURES: General health status, physical function, emotional role, Exercise Self-Efficacy Scale (ESE), physical activity (PA), and frequency of pain at each joint. RESULTS: Reported pain frequency were 66.3%, 54.4%, 42.2%, and 24.1% for lower back, knee, shoulder, and wrist, respectively. Higher obesity levels were associated with lower physical function (r=-0.109, p=0.284). PA decreased with higher obesity levels (r=-0.248, p<0.05), particularly in moderate PA (r=-0.293, p<0.05). Obesity was associated with a lower ESE (r=-0.239, p<0.05). Wrist pain significantly mediated the effect of obesity on moderate physical function, emotional role, and ESE. ESE was a significant mediator between obesity and moderate and vigorous PA. CONCLUSIONS: Overweight and obese nursing home employees are at higher risk for developing musculoskeletal disorders due to high demand, low control jobs, and the associated biomedical compromises while working. To increase the effectiveness of weight loss interventions for this population, the mediating effects of MS pain with higher levels of obesity should be considered.