Precarious employment and mental health in the Belgian service voucher system: the role of working conditions and perceived financial strain.

INTRODUCTION: Jobs in domestic cleaning are often conceived as 'precarious employment' (PE)-i.e. a multidimensional concept referring to accumulated adverse characteristics of employment due to workers' weak bargaining position. Against this background, the Belgian service voucher system (SVS) was implemented aimed at creating formal and stable, subsidized domestic services jobs. PURPOSE: The current study assesses the relationship between PE and mental health (WHO5) in the Belgian SVS, accounting for the potential mediating role of working conditions and perceived financial strain at the household level. METHODS: We analysed a cross-sectional sample of 1,115 Belgian SVS domestic cleaners, collected in 2019 through an online survey. A mediation model was estimated. RESULTS: The crude effect of PE on adverse mental health was strong (ß 0.545-S.E. 0.063). However, 50% of the association between PE and mental well-being was mediated by work task characteristics (quantitative demands, physical demands, task variation and autonomy) and 25% by household-level perceived financial strain. The remaining direct effect of PE on adverse mental well-being is ß 0.066 (S.E. 0.032-25% of the total effect). CONCLUSION: These findings are the first based on the Belgian Employment Precariousness Scale (EPRES-BE) and are consistent with earlier-made-but seldom simultaneously tested-assumptions on the mechanisms relating PE to adverse mental health-i.e. involving direct associations and indirect associations via adverse working conditions and material deprivation. Based on the results, we recommend more democratic and higher-quality management practices in the SVS, in addition to higher wages and working time reduction.

'I'm a bit of an invisible worker' - Health care and social sector students' experiences of casual and temporary agency work.

OBJECTIVES: In the wake of national and global personnel shortages, it is becoming increasingly common for students to undertake casual and temporary agency work in the health care and social sectors. This phenomenon can have both advantages and disadvantages for these workers. The objective of this study was to describe health care and social sector students' experiences of such work. METHODS: Students currently undertaking casual work in the health care and social sector in Finland were recruited (n = 28). Qualitative semi-structured interviews of these students were conducted in March to May 2021. The data were analysed using inductive content analysis. RESULTS: Respondents reported some positive aspects of casual work. In particular, they liked the freedom to choose the workplace and working times that suited them. However, respondents' experiences were mostly negative. They perceived the induction into work as being insufficient, felt they had too few opportunities to give and receive feedback and believed they were not accepted into the working community. CONCLUSIONS: Students who have bad experiences while undertaking causal work in the health care and social sectors may develop an aversion towards working in those sectors after graduating. In order to ensure the sectors are attractive to graduates, casual student workers' induction and experience of the workplace must be improved.

Design and development of a digital intervention for workplace stress and mental health (EMPOWER).

Purpose: We describe the design and development of the European Platform to Promote health and wellbeing in the workplace (EMPOWER) digital intervention that provides an integrative user programme meeting the needs of employees and employers in addressing work stress. Results: A user-centred design process was followed from January 2020 until November 2021. A tailored algorithm was developed to provide support at the individual employee level and the company level. Each element of the digital intervention was developed in English and then translated in Spanish, English, Polish and Finnish. The digital intervention consists of a website and a mobile application (app) that provides algorithm-based personalised content after assessing a user's somatic and psychological symptoms, work functioning, and psychosocial risk factors for work stress. It has a public section and an employer portal that provides recommendations to reduce psychosocial risks in their company based upon clustered input from employees. Usability testing was conducted and showed high ease of use and completion of tasks by participants. Conclusion: The EMPOWER digital intervention is a tailored multimodal intervention addressing wellbeing, work stress, mental and physical health problems, and work productivity. This will be used in a planned RCT in four countries to evaluate its effectiveness.

Does employment status matter for job quality? A cross-national perspective.

BACKGROUND: Dual labour market theory raises questions about the relationship between non-standard employment and job quality. While scattered empirical evidence exists, there is a paucity of systematic evidence on the relationship between workers' employment status and job quality. OBJECTIVE: The authors investigated the relation between workers' employment status (e.g., open-ended, long- and short-term fixed contracts, economically dependent and independent solo self-employment, and self-employment with employees) and important dimensions of job quality (JQ) (e.g., employment prospects, physical work environment, skills and discretion, and working times quality). Cross-national variation in that relation and causes of that variation (e.g., country-level unemployment rate and labour market efficiency) were also investigated. METHODS: Hierarchical regression modelling was applied using a sample of 34,094 workers from the European Working Conditions Survey 2015. RESULTS: The study highlighted a negative association between fixed-term contracts and JQ. For self-employed workers (except economically dependent self-employed workers) a generally positive association was observed. In this study, also positive associations were found between labour market efficiency at the country-level and some JQ indicators. National unemployment rates were negatively associated to most JQ indicators. CONCLUSION: Non-standard employment contracts exhibited poorer job quality than open-ended contracts. Stronger labour market organization centred around indicators of both flexibility and equity related to more beneficial job quality for all employment statuses, thereby promoting more labour market inclusivity.

Study protocol of EMPOWER: A cluster randomized trial of a multimodal eHealth intervention for promoting mental health in the workplace following a stepped wedge trial design.

Objective: This article describes the EMPOWER study, a controlled trial aiming to determine the effectiveness and cost-effectiveness of an eHealth intervention to prevent common health problems and reduce presenteeism and absenteeism in the workplace. Intervention: The EMPOWER intervention spans universal, secondary and tertiary prevention and consists of an eHealth platform delivered via a website and a smartphone app designed to guide employees throughout different modules according to their specific profiles. Design: A stepped-wedge cluster randomized trial will be implemented in four countries (Finland, Poland, Spain and UK) with employees from small and medium enterprises (SMEs) and public agencies. Companies will be randomly allocated in one of three groups with different times at which the intervention is implemented. The intervention will last 7 weeks. Employees will answer several questionnaires at baseline, pre- and post-intervention and follow-up. Outcome measures: The main outcome is presenteeism. Secondary outcomes include depression, anxiety, insomnia, stress levels, wellbeing and absenteeism. Analyses will be conducted at the individual level using the intention-to-treat approach and mixed models. Additional analyses will evaluate the intervention effects according to gender, country or type of company. Cost-effectiveness and cost-utility analyses [based on the use of quality-adjusted life-years (QALYS)] will consider a societal, employers' and employees' perspective.

What's up with the self-employed? A cross-national perspective on the self-employed's work-related mental well-being.

Although many governments actively stimulate self-employment, their work-related mental well-being remains understudied. The aim of current study is to investigate the mental well-being of different types of self-employed, testing whether mental well-being differences among self-employed are explained by the presence of work characteristics that are in accordance with the ideal-typical image of the "successful entrepreneur" (e.g. creativity, willingness to take risks, innovativeness, high intrinsic motivation, skilfulness and the ability of recognizing opportunities). Moreover, we investigate the relation of country-level "entrepreneurial climate" and the individual mental well-being of self-employed. For this purpose, data from the European Working Conditions Survey, round 6 (2015) was analysed, including 5448 cases, originating from the 28 EU-member states. Multilevel random intercepts modelling was used to investigate associations of both individual- and country-level characteristics with mental well-being. We found that motivation, the ability to recognize opportunities, and finding it easy to be self-employed positively influences the mental well-being of self-employed. Respondents with these characteristics are often medium-big employers, while farmers, dependent freelancers and own account workers generally have less of these features and tend to have lower levels of mental well-being. At the country-level, positive entrepreneurship perception relates to more advantageous mental health scores in self-employed. These results implicate that policies promoting self-employment should be (more) concerned with the work-related characteristics of (future) self-employed.