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Employees in Georgia Presentation to: APHA Conference 2017 - - PowerPoint PPT Presentation

Spring out of Burnout: A Theory Driven Stress Management Intervention for State Public Health Employees in Georgia Presentation to: APHA Conference 2017 Presented by: Carmen N. Daniel, MPH November 8, 2017 Date: Presenter Disclosures No


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Presentation to: Presented by: Date:

Spring out of Burnout: A Theory Driven Stress Management Intervention for State Public Health Employees in Georgia

APHA Conference 2017 Carmen N. Daniel, MPH November 8, 2017

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Presenter Disclosures

No relationships to disclose.

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Learning Objectives

1. Identify the benefits of work-related stress management interventions in workplaces. 2. Explain the barriers in accessing stress management resources in organizations of 1,000 employees or larger. 3. Discuss how to implement a theory driven, population specific stress management program. 4. Recognize the value of a stress management program to address work-related stressors. Adapt a workplace stress model.

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Program Sequence

Stage 1

  • Health Climate

Survey Stage 2

  • Surveys (1-on-

1; online) Stage 3

  • Program

Development Stage 4

  • Program

Execution Stage 5

  • Evaluation and

Dissemination

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Health Climate Survey

Stage 1

  • Health

Climate Survey Stage 2

  • Surveys (1-
  • n-1; online)

Stage 3

  • Program

Development Stage 4

  • Program

Execution Stage 5

  • Evaluation

and Dissemination

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Significant Stress Correlations

Variable Pearson Correlation P-value

Consideration of participating in programs

Employee Assistance Program (EAP)

  • 0.161

0.006 Work-Life Balance

  • 0.124

0.035

Physical/Emotion Problems (Work Limitations Questionnaire)

WLQ Time Domain 0.459 <0.001 WLQ Mental Demands Domain 0.394 <0.001 WLQ Output Domain 0.441 <0.001

Current job questions on job satisfaction/stress at work

Generally speaking, I am very satisfied with my job. 0.487 <0.001 I am generally satisfied with the kind of work I do in this job. 0.288 <0.001 Variable Pearson Correlation P-value Travel for work 0.131 0.028 Depression Scale 0.337 <0.001 How often do you drink alcoholic beverages? 0.119 0.044 How would you rate your sleep

  • verall?

0.211 <0.001 Work-life Balance Scale 0.473 <0.001

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Stress Correlations*

Variable Label Employee Assistance Program (EAP) Participation 0=not participated, 1=participated Stress Awareness Program Participation 0=not participated, 1=participated

Employees who participated in EAP had higher stress. Employees who participated in stress awareness programs had lower stress scores.

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Health Climate Survey

Stage 1

  • Health

Climate Survey Stage 2

  • Surveys (1-
  • n-1; online)

Stage 3

  • Program

Development Stage 4

  • Program

Execution Stage 5

  • Evaluation

and Dissemination

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Preliminary Research – Qualitative Interviews

  • Signed and verbal consent
  • Recorded informal

interviews with outside consultant

  • Qualitative Interviews

(Formative)

  • Confidentiality

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Qualitative Informal Interviews

Field Example Questions Demographics “Job Title” “How many people do you supervise?” “How many people are on the team?” Baseline Assessment “Are you stressed?” “What would you say are your main causes of stress at work? “Does it interfere with your personal life?” “Do you currently experience stress outside of work? If so, how would you say that stress compares to the stress you feel at work?” Self-Report: Social Influence

  • n Stress

“How valued do you feel at work?” “Do you feel apart of the team?” Self-Report: Job Efficiency “Do you value your work?” “Do you feel you have enough time to get tasks done?” Current Methods of Controlling Stress Levels “What do you do/use to ease your stress? What has worked and what hasn’t?” Other “How can DPH support you and address your needs relating to stress?” “Is there anything you’d like to share about your stress levels at work?”

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Online Survey and Recruitment

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Online Survey

Field Example Questions Response options Characteristics

  • f Work

“The number of projects and/or assignments I have.” “The time pressures I experience” “The level of job security I have.”

  • Produces no stress.
  • Produces a little stress.
  • Produces tolerable stress.
  • Produces a lot of stress.
  • Produces excessive stress.
  • N/A

Clarity of Objectives “The degree to which relationships rather than performance affects organizational decisions.” “The ability to accomplish my job while adhering to policies and procedures.” Time and Travel “The amount of time I spend in meetings.” “The amount of traveling I must do.” Additional comments and Location

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Program Development

Stage 1

  • Health

Climate Survey Stage 2

  • Surveys (1-
  • n-1; online)

Stage 3

  • Program

Development Stage 4

  • Program

Execution Stage 5

  • Evaluation

and Dissemination

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Transactional Model of Stress and Coping

  • Overarching

programmatic focus

  • Constructs

– Attitudes – Knowledge – Skill – Self-efficacy – Barriers – Intention – Social support

(“Transactional Model,” 2016)

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Transactional Model of Stress and Coping

Stage 1- Appraisal of Stress

Primary Appraisal Insufficient coping resources Individual’s judgment Analysis of resources to insure positive outcome Positive or Desirable Irrelevant or Insignificant Dangerous Secondary Appraisal

Stage 2- Coping

Problem-focused Emotion-Focused

Constructs

Constructs

  • Attitude
  • Knowledge
  • Skills
  • Active coping
  • Problem solving
  • Information

seeking

  • Self-efficacy
  • Social support
  • Avoidance of

particular situations

  • Distancing oneself

from events

  • Seeking emotional

support from

  • thers
  • Venting feelings

(Editor, P., 2015)

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Transactional Model of Stress and Coping

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Program Logic Model

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Matrices of Change

Behavioral Performance Objectives (BPO)

BPO Knowledge Self- Efficacy Attitudes Beliefs BPO.1 K.1 SE.1 AB.1 BPO.2 K.2 SE.2 AB.2 BPO.3 K.3.a. K.3.b. SE.3 AB.3.a. AB.3.b. BPO.4 K.4 SE.4.a. SE.4.b. AB.4

Environmental Performance Objectives (EPO)

EPO Attitudes & Beliefs Cost & Affordability EPO.1 AB.1 CA.1.a. CA.1.b. CA.1.c. EPO.2 AB.2 CA.2 EPO.3 AB.3.a. AB.3.b CA.3

See handout for detailed descriptions

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Methods and Strategies

See handout for detailed descriptions

Behavioral Determinants BPO.1 – BPO.4 Determinant & Change Objectives Methods Strategies Program Components Knowledge Self-Efficacy Attitudes & Beliefs BPO.4

Behavioral Determinants

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Methods and Strategies

See handout for detailed descriptions

Environmental Determinants EPO.1 – EPO.4 Determinant & Change Objectives Methods Strategies Program Components Attitudes & Beliefs Cost & Affordability

Environmental Determinants

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Program Development

Stage 1

  • Health

Climate Survey Stage 2

  • Survey: (1-on-

1; online) Stage 3

  • Program

Development Stage 4

  • Program

Execution Stage 5

  • Evaluation

and Dissemination

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Process & Outcome Evaluations

See handout for detailed descriptions

  • Program effectiveness
  • Program efficacy
  • Quality of programmatic components

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Contact Information

Presenter Carmen N. Daniel, MPH, CWWPM Worksite Wellness Program Manager Georgia Department of Public Health Workforce Management – Worksite Wellness Carmen.Daniel@dph.ga.gov

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References

American Psychological Association. (2017, February 15). Many Americans Stressed about Future of Our Nation, New APA Stress in America™ Survey Reveals [Press release]. Retrieved February 20, 2017, from http://www.apa.org/news/press/releases/2017/02/stressed-nation.aspx American Psychological Association. (2017, February 15). Stress In America: Coping with Change[Press release]. Retrieved February 20, 2017, from http://www.apa.org/news/press/releases/stress/2016/coping-with-change.pdf

  • Cope. (n.d.). Retrieved April 26, 2017, from https://www.merriam-webster.com/dictionary/cope

Doran, K., Resnick, B., Kim, N., Lynn, D., & McCormick, T. (2017). Applying the Social Ecological Model and Theory of Self-Efficacy in the Worksite Heart Health Improvement Project-PLUS. Research and Theory for Nursing Practice, 31(1), 8-27. Editor, P. (2015, January 21). Transactional Model of Stress and Coping. Retrieved April 26, 2017, from https://flowpsychology.com/transactional-model-of-stress-and-coping/ Grawitch, M. J., Ballard, D. W., & Erb, K. R. (2015). To be or not to be (stressed): The critical role of a psychologically healthy workplace in effective stress management. Stress and Health, 31(4), 264-273. Harvey, S. B., Modini, M., Joyce, S., Milligan-Saville, J. S., Tan, L., Mykletun, A., ... & Mitchell, P. B. (2017). Can work make you mentally ill? A systematic meta-review of work-related risk factors for common mental health

  • problems. Occup Environ Med, oemed-2016.

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References

Health Behavior and Health Education. (n.d.). Retrieved April 15, 2017, from http://www.med.upenn.edu/hbhe4/part3-ch10-key-constructs.shtml Health Communication | Transactional Model of Stress and Coping. (n.d.). Retrieved April 16, 2017, from https://www.utwente.nl/en/bms/communication-theories/sorted-by- cluster/Health%20Communication/transactional_model_of_stress_and_coping/ High Demand - Low Control. (2010, April 15). Retrieved April 18, 2017, from http://web.uvic.ca/~mrwright/a3/karasek.html Highlights: Workplace Stress & Anxiety Disorders Survey. (n.d.). Retrieved February 20, 2017, from https://www.adaa.org/workplace-stress-anxiety-disorders-survey Jacobs, S., Johnson, S., & Hassell, K. (2017). Managing workplace stress in community pharmacy organisations: lessons from a review of the wider stress management and prevention literature. International Journal of Pharmacy Practice. Leão, E. R., Dal Fabbro, D. R., de Oliveira, R. B., dos Santos, I. R., da Silva Victor, E., Aquarone, R. L., ... & Ferreira, D. S. (2017). Stress, self-esteem and well-being among female health professionals: A randomized clinical trial on the impact of a self-care intervention mediated by the senses. PloS one, 12(2), e0172455.

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References

Li, J., Grosch, J., & Alterman, T. (2006, June). Job stress and incidence of cardiovascular disease among older workers in the health and retirement study. In AMERICAN JOURNAL OF EPIDEMIOLOGY (Vol. 163, No. 11, pp. S215-S215). JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA: OXFORD UNIV PRESS INC. Main Causes of Stress [Digital image]. (n.d.). Retrieved from https://www.stress.org/workplacestress Mijakoski, D., Karadzinska-Bislimovska, J., Basarovska, V., Montgomery, A., Panagopoulou, E., Stoleski, S., & Minov, J. (2015). Burnout, Engagement, and Organizational Culture: Differences between Physicians and Nurses. Open Access Macedonian Journal of Medical Sciences, 3(3), 506. Nowrouzi, B., Lightfoot, N., Larivière, M., Carter, L., Rukholm, E., Schinke, R., & Belanger Gardner, D. (2015). Occupational stress management and burnout interventions in nursing and their implications for healthy work environments: a literature review. Workplace health & safety, 63(7), 308-315. Job burnout: How to spot it and take action. (2015, September 17). Retrieved April 16, 2017, from http://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/burnout/art-20046642 Sauter, S. (2007, December 3). Workplace Stress [Web log post]. Retrieved February 20, 2017, from https://blogs.cdc.gov/niosh-science-blog/2007/12/03/stress/

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References

Simoneau, T. L., Kilbourn, K., Spradley, J., & Laudenslager, M. L. (2017). An evidence-based stress management intervention for allogeneic hematopoietic stem cell transplant caregivers: development, feasibility and acceptability. Supportive Care in Cancer, 1-9. STRESS AT WORK. (2013, August 29). Retrieved February 23, 2017, from https://www.cdc.gov/niosh/topics/stress/ Transactional Model of Stress and Coping [Digital image]. (2016, October 16). Retrieved April 4, 2017, from https://commons.wikimedia.org/wiki/File:Transactional_Model_of_Stress_and_Coping_-_Richard_Lazarus.svg What is EAP? (n.d.). Retrieved April 16, 2017, from https://www.easna.org/research-and-best practices/what-is-eap/ Wiglesworth, S., & Farnworth, L. (2016). An Exploration of the Use of a Sensory Room in a Forensic Mental Health Setting: Staff and Patient Perspectives. Occupational therapy international, 23(3), 255-264. Workplace Stress. (2017, January 04). Retrieved February 23, 2017, from https://www.stress.org/workplace-stress/ Żołnierczyk-Zreda, D., Sanderson, M., & Bedyńska, S. (2016). Mindfulness-based stress reduction for managers: a randomized controlled study. Occupational Medicine, 66(8), 630-635.

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