RESUMO
The Community of Practice and Safety Support (COMPASS) program is a peer-led group intervention for home care workers. In a randomized controlled trial, COMPASS significantly improved workers' professional support networks and safety and health behaviors. However, quantitative findings failed to capture workers' complex emotional, physical, and social experiences with job demands, resource limitations, and the intervention itself. Therefore, we conducted qualitative follow-up interviews with a sample of participants (n = 28) in the program. Results provided examples of unique physical and psychological demands, revealed stressful resource limitations (e.g., safety equipment access), and elucidated COMPASS's role as a valuable resource.
Assuntos
Recursos em Saúde/provisão & distribuição , Serviços de Assistência Domiciliar/normas , Enfermeiros de Saúde Comunitária/psicologia , Apoio Social , Carga de Trabalho/normas , Serviços de Assistência Domiciliar/tendências , Humanos , Relações Enfermeiro-Paciente , Oregon , Salários e Benefícios/tendências , Carga de Trabalho/psicologiaRESUMO
OBJECTIVES: To understand the influences associated with durability and diffusion of benefits of a fire service wellness program. METHODS: Qualitative assessment of group interviews. RESULTS: Five years following a controlled worksite wellness trial, behavioral improvements were durable and had diffused to control participants. These findings were associated with firefighters' team orientation, enacted healthy norms and competitiveness regarding the results of annual health assessments. The original intervention trial appeared to initiate individual change that coalesced into group effects. Secondary influences included increasing public awareness about health, newly hired younger firefighters, and a modicum of administrative support. Culture shift was achieved at the workplace. CONCLUSIONS: Although the fire service is a unique occupation, these findings suggest general strategies to achieve durable positive health change in other occupational settings.
Assuntos
Bombeiros/psicologia , Comportamentos Relacionados com a Saúde , Promoção da Saúde , Avaliação de Resultados em Cuidados de Saúde , Adulto , Feminino , Grupos Focais , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Local de TrabalhoRESUMO
OBJECTIVE: To identify and evaluate determinants of fire departments' wellness program adoption. METHODS: The Promoting Healthy Lifestyles: Alternative Models' Effects fire service wellness program was offered for free to all medium-sized fire departments in Oregon and Washington. An invitation to participate was mailed to key fire department decision makers (chief, union president, and wellness officer). These key decision makers from 12 sites that adopted the program and 24 matched nonadopting sites were interviewed and results were analyzed to define adoption determinants. RESULTS: Three adoption requirements were identified: (1) mailer connection, (2) local firefighter wellness champion, and (3) willing fire chief, whereas a fourth set of organizational factors had little or no impact on adoption including previous and ongoing wellness activities, financial pressures, and resistance to change. CONCLUSIONS: Findings identified determinants of medium-sized fire service wellness program adoption.
Assuntos
Bombeiros , Promoção da Saúde/organização & administração , Modelos Organizacionais , Saúde Ocupacional , Humanos , Oregon , Estudos Prospectivos , Pesquisa Qualitativa , Comportamento de Redução do Risco , WashingtonRESUMO
Occupational health promotion programs with documented efficacy have not penetrated worksites. Establishing an implementation model would allow focusing on mediating aspects to enhance installation and use of evidence-based occupational wellness interventions. The purpose of the study was to implement an established wellness program in fire departments and define predictors of program exposure/dose to outcomes to define a cross-sectional model of translational effectiveness. The study is a prospective observational study among 12 NW fire departments. Data were collected before and following installation, and findings were used to conduct mediation analysis and develop a translational effectiveness model. Worker age was examined for its impact. Leadership, scheduling/competing demands, and tailoring were confirmed as model components, while organizational climate was not a factor. The established model fit data well (χ (2)(9) = 25.57, CFI = 0.99, RMSEA = 0.05, SRMR = 0.03). Older firefighters, nearing retirement, appeared to have influences that both enhanced and hindered participation. Findings can inform implementation of worksite wellness in fire departments, and the prioritized influences and translational model can be validated and manipulated in these and other settings to more efficiently move health promotion science to service.