Evaluating the Health Benefits of Workplace Policies and Practices - Phase II

Study Overview
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Brief Summary
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Although the prevalence of family-friendly policies in US workplaces has increased dramatically, few have been studied using scientifically sound designs. To address this, the NIH and CDC formed the Work, Family, and Health Network (WFHN). During Phase 1, the WFHN designed and conducted multiple pilot and feasibility studies. For Phase 2, the WFHN implemented an innovative intervention based on Phase I pilot studies that is designed to increase family-supportive supervisor behaviors and employee control over work, and to evaluate the intervention using a group randomized experimental design. Customized interventions were performed separately in workplaces of two separate corporate partners.

Detailed Description
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Although the prevalence of family-friendly policies in US workplaces has increased dramatically in recent years, few have been studied using scientifically sound designs. To address this critical gap, the NIH and CDC formed the Work, Family, and Health Network (WFHN). During Phase 1, the WFHN designed and conducted multiple pilot and feasibility studies. For Phase 2, the WFHN implemented an innovative intervention based on Phase 1 pilot studies that is designed to increase family-supportive supervisor behaviors and employee control over work, and to evaluate the intervention using a group randomized experimental design. The goal of the study is to assess the effects of a workplace intervention designed to reduce work-family conflict, and thereby improve the health and well being of employees. The study intervention is grounded in theory from multiple disciplines and supported by findings from pilot/feasibility studies. The study seeks to inform the implementation of evidence-based, family-friendly policies, and thereby improving the health and well-being of employees and their families nationwide. The investigators assess the efficacy of the intervention via two independent, group-randomized field experiments, one at each of two employers representing different industries, referred to by alias as LEEF and TOMO. LEEF is an extended care (nursing home) company and facilities were excluded if they were in very isolated settings, if there were fewer than 30 direct patient-care employees, or if facilities were recently acquired. TOMO is an Information Technology company. Within each industry partner, worksites of 50-120 employees each were randomly assigned to intervention or usual practice conditions. All employee and supervisor participants were assessed at baseline and at 6-, 12-, and 18-months post baseline, including survey interviews and health assessments. Primary health outcomes were comprised of a cardiometabolic risk score using selected biomarkers and sleep duration and quality objectively measured using wrist actigraphy. These primary health outcomes were independently assessed as change from baseline to the 12-month wave, and separately in the two industries.

Official Title
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Evaluating the Health Benefits of Workplace Policies and Practices - Phase II

Conditions
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Focus of Study: Work Conditions

Intervention / Treatment
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* Behavioral: Intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: LEEF: employees and supervisors with at least 22 weekly hours of direct patient care work in selected facilities TOMO: employees and supervisors located in the two data collection cities Exclusion Criteria: LEEF: nightwork schedule TOMO: independent contractor classification
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: LEEF Industry only: Intervention<br>Customized to the Leef (alias) workplace: A 3-month structural and social change process designed to increase employee control over work time and family supportive supervisory behaviors. | Behavioral: Intervention<br>* The intervention was a 3-month structural and social change process designed to increase employee control over work time and family supportive supervisory behaviors (Kossek et al., in press). The change process was an integration of two previously evaluated interventions (Hammer et al., 2011; Kelly et al., 2011). A facilitator led 8 hrs of participatory sessions to transition employees from a time-based to a results-based work culture. Supervisors participated in all change activities plus 4hrs of training in supportive supervision. Training in family supportive supervision was implemented with behavioral computer-based training (cTRAIN, NWeta, Lake Oswego, OR) followed by 2 rounds of goal-setting and behavioral self-monitoring using an iPod Touch (Habitrack, OHSU, Portland, OR).<br>|
| No Intervention: LEEF Industry only: Usual Practice<br>Continued work conditions and practice as Usual Practice in that workplace | |
| Experimental: TOMO Industry only: Intervention<br>Customized to the Tomo (alias) workplace: A 3-month structural and social change process designed to increase employee control over work time and family supportive supervisory behaviors. | Behavioral: Intervention<br>* The intervention was a 3-month structural and social change process designed to increase employee control over work time and family supportive supervisory behaviors (Kossek et al., in press). The change process was an integration of two previously evaluated interventions (Hammer et al., 2011; Kelly et al., 2011). A facilitator led 8 hrs of participatory sessions to transition employees from a time-based to a results-based work culture. Supervisors participated in all change activities plus 4hrs of training in supportive supervision. Training in family supportive supervision was implemented with behavioral computer-based training (cTRAIN, NWeta, Lake Oswego, OR) followed by 2 rounds of goal-setting and behavioral self-monitoring using an iPod Touch (Habitrack, OHSU, Portland, OR).<br>|
| No Intervention: TOMO Industry only: Usual Practice<br>Continued work conditions and practice as Usual Practice in that workplace | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in total sleep time | Average 24 hour total sleep time as assessed by  1 week of actigraphy | baseline to one year later | 
| change in wake after sleep onset | Amount of nightime wake after sleep onset as assessed by  1 week of actigraphy | baseline to one year later | 
| change in cardiometabolic risk score | The cardiometabolic risk score was created based on modifiable risk factors using an independently validated CVD risk score developed from the Framingham offspring study; including BMI, blood pressure, HbA1C, cholesterol, and tobacco consumption. | baseline to one year later | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| change in sleep insufficiency | Sleep insufficiency was assessed by the following question: How often during the past 4 weeks did you get enough sleep to feel rested upon waking up? Would you say never, rarely, sometimes, often, or very often? YES - NEVER/RARELY NO - SOMETIMES OFTEN VERY OFTEN | baseline to one year later | 
| change in insomnia symptoms | Insomnia symptoms were assessed by the following question: During the past 4 weeks, how often did you wake up in the middle of the night or early morning? (Would you say never, less than once a week, once or twice a week, or three or more times a week?) YES - THREE OR MORE TIMES A WEEK NO - NEVER/LESS THAN ONCE A WEEK/ONCE OR TWICE A WEEK | baseline to one year later | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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work to family conflict, supervisor support, long work hours, cardiometabolic risk, sleep duration, insomnia symptoms