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Objectives. To examine whether workplace interventions to increase workplace flexibility and supervisor support and decrease work–family conflict can reduce cardiometabolic risk. Methods. We randomly assigned employees from information technology (n = 555) and long-term care (n = 973) industries in the United States to the Work, Family and Health Network intervention or usual practice (we collected the data 2009–2013). We calculated a validated cardiometabolic risk score (CRS) based on resting blood pressure, HbA 1c (glycated hemoglobin), HDL (high-density lipoprotein) and total cholesterol, height and weight (body mass index), and tobacco consumption. We compared changes in baseline CRS to 12-month follow-up. Results. There was no significant main effect on CRS associated with the intervention in either industry. However, significant interaction effects revealed that the intervention improved CRS at the 12-month follow-up among intervention participants in both industries with a higher baseline CRS. Age also moderated intervention effects: older employees had significantly larger reductions in CRS at 12 months than did younger employees. Conclusions. The intervention benefited employee health by reducing CRS equivalent to 5 to 10 years of age-related changes for those with a higher baseline CRS and for older employees. Trial Registration. ClinicalTrials.gov  Identifier: NCT02050204. (Am J Public Health. 2023;113(12):1322–1331. https://doi.org/10.2105/AJPH.2023.307413 )

Objectives. To evaluate the effectiveness of the Safety and Health Involvement For Truckers (SHIFT) intervention with a randomized controlled design. Methods. The multicomponent intervention was a weight-loss competition supported with body weight and behavioral self-monitoring, computer-based training, and motivational interviewing. We evaluated intervention effectiveness with a cluster-randomized design involving 22 terminals from 5 companies in the United States in 2012 to 2014. Companies were required to provide interstate transportation services and operate at least 2 larger terminals. We randomly assigned terminals to intervention or usual practice control conditions. We assessed participating drivers (n = 452) at baseline and 6 months. Results. In an intent-to-treat analysis, the postintervention difference between groups in mean body mass index change was 1.00 kilograms per meters squared (P < .001; intervention = −0.73; control = +0.27). Behavioral changes included statistically significant improvements in fruit and vegetable consumption and physical activity. Conclusions. Results establish the effectiveness of a multicomponent and remotely administered intervention for producing significant weight loss among commercial truck drivers.

Workplace redesign in the 21st Century is eloquently addressed by Lovejoy et al. in this issue of AJPH (p. 1787). The authors discuss the interplay of workplace redesign and public policy and the health and well-being of workers and their families. For example, the trend toward precarious work, where people of color are overrepresented, offers little job security or benefits, discourages organized labor, and continues the proliferation of low wages. At the same time, the US workforce is increasingly diverse, some workplaces are more flexible as a result of the pandemic, the importance of paid leave is being recognized, labor efforts supporting the PRO Act (HR 842; Protecting the Right to Organize Act of 2021) are expanding, and there is more emphasis on \"green jobs\"; all of these provide a potentially optimistic forecast for worker health and well-being. Rapidly developing workplace redesign efforts resulting from the movement toward robotics and artificial intelligence, COVID-19 (e.g., increased hybrid work), and novel public policies on such issues as family and medical leave, safety and health, scheduling notification and work hours, and unionization should be studied to determine their impacts on worker well-being.As Lovejoy et al. and others describe, an expanded view of traditional occupational safety and health is needed, which has demonstrated that in addition to physical hazards at work, many workers face psychosocial hazards.1 These include aggression from co-workers and supervisors, work-family stress, heightened job demands resulting from workplace intensification, high stress associated with perceived lack of control, low workplace (e.g., supervisor) support, and less meaningful work. The increase in artificial intelligence and robotics, albeit an important tool for reducing occupational injuries, can contribute to workers' psychological stress and job insecurity.2Job insecurity leads to economic insecurity, food insecurity, and negative psychological and physical outcomes. Therefore, we need national policies to provide basic health care, family care, shelter, and food assistance to mitigate the impact of these stressors on workers and their families. Nonwork activities and responsibilities and quality of life must be considered in the redesign of work, as the importance of personal relationships and connections to the natural environment to health are becoming increasingly acknowledged.

Purpose The present study examined the moderating effects of family-supportive supervisor behaviors (FSSB) on the relationship between two types of workplace aggression (i.e., patient-initiated physical aggression and coworker-initiated psychological aggression) and employee well-being and work outcomes. Methodology Data were obtained from a field sample of 417 healthcare workers in two psychiatric hospitals. Hypotheses were tested using moderated multiple regression analyses. Findings Psychiatric care providers’ perceptions of FSSB moderated the relationship between patient-initiated physical aggression and physical symptoms, exhaustion and cynicism. In addition, FSSB moderated the relationship between coworker-initiated psychological aggression and physical symptoms and turnover intentions. Implications Based on our findings, family-supportive supervision is a plausible boundary condition for the relationship between workplace aggression and well-being and work outcomes. This study suggests that, in addition to directly addressing aggression prevention and reduction, family-supportive supervision is a trainable resource that healthcare organizations should facilitate to improve employee work and well-being in settings with high workplace aggression. Originality This is the first study to examine the role of FSSB in influencing the relationship between two forms of workplace aggression: patient-initiated physical and coworker-initiated psychological aggression and employee outcomes.

Links between loneliness and health are robust, though evidence for associations with alcohol use is mixed. Previous research has supported perceived stress as a predictor of alcohol use and as a pathway through which loneliness impacts health over time. Yet findings are primarily limited to civilian samples, and less is known about how loneliness relates to stress and health among service members. The current study explores prospective associations among loneliness, stress, and health (i.e., sleep, alcohol misuse, and psychological distress) within a sample of mostly male service members. We examine two dimensions of perceived stress, perceived helplessness and negative coping appraisal, as explanatory mechanisms. Controlling for baseline stress and health, loneliness predicted perceived helplessness and negative coping appraisal (4-month follow-up); in turn, perceived helplessness and negative coping appraisal predicted insomnia and sleep dissatisfaction; and negative coping appraisal predicted alcohol misuse (indirect effects). Findings support transactional models of stress and the stressor-vulnerability model of alcohol use, revealing that coping appraisals play an important explanatory role for stress-related consequences of loneliness. Further, we provide new insight into mechanisms linking loneliness to alcohol use and sleep, differentiating dimensions of stress and highlighting potential intervention targets.

Schedule control and supervisor support for family and personal life may help employees manage the work-family interface. Existing data and research designs, however, have made it difficult to conclusively identify the effects of these work resources. This analysis utilizes a group-randomized trial in which some units in an information technology workplace were randomly assigned to participate in an initiative, called STAR, that targeted work practices, interactions, and expectations by (1) training supervisors on the value of demonstrating support for employees' personal lives and (2) prompting employees to reconsider when and where they work. We find statistically significant, although modest, improvements in employees' work-family conflict and family time adequacy, and larger changes in schedule control and supervisor support for family and personal life. We find no evidence that this intervention increased work hours or perceived job demands, as might have happened with increased permeability of work across time and space. Subgroup analyses suggest the intervention brought greater benefits to employees more vulnerable to work-family conflict. This study uses a rigorous design to investigate deliberate organizational changes and their effects on work resources and the work-family interface, advancing our understanding of the impact of social structures on individual lives.

OBJECTIVE:Review relationships between work–life stress and health behaviors to advance understanding of pathways between occupational and individual risk factors and health and safety outcomes. METHODS:A background on the Total Worker Health concept is provided, and a review of research on the relationship between work–life stress and health behaviors is presented. RESULTS:Research evidence indicates that work–life stress serves as a negative occupational exposure relating to poor health behaviors, including smoking, poor food choices, low levels of exercise, and even decreased sleep time. CONCLUSION:The association between work–life stress and adverse health behaviors suggests that interventions at both the occupational (health protection) and individual (health promotion) level may be helpful in mitigating effects of work–life stress, consistent with the Total Worker Health approach. Further study is needed to investigate gains from an integrated prevention strategy.

The attention to workplace mental health is timely given extreme levels of burnout, anxiety, depression and trauma experienced by workers due to serious extraorganizational stressors – the COVID-19 pandemic, threats to climate change, and extreme social and political unrest. Workplace-based risk factors, such as high stress and low support, are contributing factors to poor mental health and suicidality (Choi, 2018; Milner et al., 2013, 2018), just as low levels of social connectedness and belonging are established risk factors for poor mental health (Joiner et al., 2009), suggesting that social support at work (e.g., from supervisors) may be a key approach to protecting and promoting employee mental health. Social connections provide numerous benefits for health outcomes and are as, or more, important to mortality as other well-known health behaviors such as smoking and alcohol consumption (Holt-Lundstad et al., 2015), and can serve as a resource or buffer against the deleterious effects of stress or strain on psychological health (Cohen & Wills, 1985). This manuscript provides an evidence-based framework for understanding how supervisor supportive behaviors can serve to protect employees against psychosocial workplace risk factors and promote social connection and belongingness protective factors related to employee mental health. We identify six theoretically-based Mental Health Supportive Supervisor Behaviors (MHSSB; i.e., emotional support, practical support, role modeling, reducing stigma, warning sign recognition, warning sign response) that can be enacted and used by supervisors and managers to protect and promote the mental health of employees. A brief overview of mental health, mental disorders, and workplace mental health is provided. This is followed by the theoretical grounding and introduction of MHSSB. Suggestions for future research and practice follow, all with the focus of developing a better understanding of the role of supervisors in protecting and promoting employee mental health in the workplace.

Objectives. The COVID-19 pandemic imposed unprecedented safety challenges on health care facilities. This study examined whether health care workers who deemed a better safety response to the pandemic by their units or employers experienced lower psychological distress. Methods. Patient care workers at a health care system in the Pacific Northwest were surveyed every 6 to 8 months from May 2020 to May 2022 (n = 3468). Psychological distress was measured with the Well-being Index (range: −2 to 7 points). Safety response was scored on the basis of participants’ ratings (on a 1–5 scale) of equipment sufficiency and responsiveness to safety concerns by their health care system and unit. Results. Adjusted multilevel regressions showed an inverse association between safety responsiveness and psychological distress at the individual level (b = −0.54; 95% confidence interval [CI] = −0.67, −0.41) and the unit level (b = −0.73; 95% CI = −1.46, −0.01). The cross-level interaction was also statistically significant (b = −0.46; 95% CI = −0.87, −0.05). Conclusions. Health care workers who deemed a better response to safety challenges reported lower psychological distress. This study highlights the need for continued efforts to ensure adequate safety resources. ( Am J Public Health. 2024;114(S2):S204–S212. https://doi.org/10.2105/AJPH.2024.307582 )