Publications

2023
Berkman LF, Kelly EL, Hammer LB, Mierzwa F, Bodner T, McNamara T, Koga HK, Lee S, Marino M, Klein LC, et al. Employee Cardiometabolic Risk Following a Cluster-Randomized Workplace Intervention From the Work, Family and Health Network, 2009–2013. American Journal of Public Health. 2023;113 (12) :1322-1331. Publisher's VersionAbstract
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, HbA1c (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)
2022
Livingston B, Pichler S, Kossek EE, Thompson RJ, Bodner T. An Alpha, Beta and Gamma Approach to Evaluating Occupational Health Organizational Interventions: Learning from the Measurement of Work-Family Conflict Change. Occup Health Sci. 2022;online ahead of print (19 August 2022) :1-31. Publisher's VersionAbstract
Given the rapid growth of intervention research in the occupational health sciences and related fields (e.g. work-family), we propose that occupational health scientists adopt an “alpha, beta, gamma” change approach when evaluating intervention efficacy. Interventions can affect absolute change in constructs directly (alpha change), changes in the scales used to assess change (beta change) or redefinitions of the construct itself (gamma change). Researchers should consider the extent to which they expect their intervention to affect each type of change and select evaluation approaches accordingly. We illustrate this approach using change data from groups of IT professionals and health care workers participating in the STAR intervention, designed by the Work Family Health Network. STAR was created to effect change in employee work-family conflict via supervisor family-supportive behaviors and schedule control. We hypothesize that it will affect change via all three change approaches—gamma, beta, and alpha. Using assessment techniques from measurement equivalence approaches, we find results consistent with some gamma and beta change in the IT company due to the intervention; our results suggest that not accounting for such change could affect the evaluation of alpha change. We demonstrate that using a tripartite model of change can help researchers more clearly specify intervention change targets and processes. This will enable the assessment of change in a way that has stronger fidelity between the theories used and the outcomes of interest. Our research has implications for how to assess change using a broader change framework, which employs measurement equivalence approaches in order to advance the design and deployment of more effective interventions in occupational settings.
2021
Leger KA, Lee S, Chandler KD, Almeida DM. Effects of a workplace intervention on daily stressor reactivity. Journal of Occupational Health Psychology. 2021. Publisher's VersionAbstract
Heightened affective and physical reactions to daily stressful events predict poor long-term physical and mental health outcomes. It is unknown, however, if an experimental manipulation designed to increase interpersonal resources at work can reduce associations between daily stressors and physical and affective well-being. The present study tests the effects of a workplace intervention designed to increase supervisor support for family and personal life and schedule control on employees’ affective and physical reactivity to daily stressors in different domains (i.e., work, home, interpersonal, and noninterpersonal stressors). Participants were 102 employed parents with adolescent children from an information technology (IT) division of a large U.S. firm who participated in the Work, Family, and Heath Study. Participants provided 8-day daily diary data at baseline and again at a 12-month follow-up after the implementation of a workplace intervention. Multilevel models revealed that the intervention significantly reduced employees’ negative affect reactivity to work stressors and noninterpersonal stressors, compared to the usual practice condition. Negative reactivity did not decrease for nonwork or interpersonal stressors. The intervention also did not significantly reduce positive affect reactivity or physical symptom reactivity to any stressor type. Results demonstrate that making positive changes in work environments, including increasing supervisor support and flexible scheduling, may promote employee health and well-being through better affective responses to common daily stressors at work.
Fox KE, Johnson ST, Berkman LF, Sianoja M, Soh Y, Kubzansky LD, Kelly EL. Organisational- and group-level workplace interventions and their effect on multiple domains of worker well-being: A systematic review. Work & Stress. 2021 :1-30. Publisher's VersionAbstract
As a social determinant of health, work influences the health and well-being of workers. Interventions to change the conditions of work are an important complement to individually-focused wellness initiatives. This systematic literature review identified organisational- and group-level workplace intervention studies using experimental or quasi-experimental designs. It considered 83 studies with well-being outcomes that span the mental health continuum from ill-being to positive mental health, including context-free well-being (e.g. psychological distress), work-specific well-being (e.g. job satisfaction), and work-family well-being (e.g. work-family conflict). Interventions were categorised into four types: flexible work and scheduling changes; job and task modifications; relational and team dynamic initiatives; and participatory process interventions. There is significant heterogeneity in conceptualisation and measurement of well-being with job satisfaction being most commonly measured. Our review finds that strategies aiming to change work conditions have the potential to improve working well-being with demonstrable effects in all three well-being domains. Regardless of type, interventions involving increased control and opportunities for workers’ voice and participation more reliably improve worker well-being, suggesting these components are critical drivers of well-being. We recommend further research incorporate process evaluation to clarify how interventions create positive changes and examine the conditions in which specific interventions may be most effective.
Lawson KM, Lee S, Maric D. Not just work-to-family conflict, but how you react to it matters for physical and mental health. Work & Stress. 2021 :1-17. Publisher's VersionAbstract
ABSTRACT Individuals with higher work-to-family conflict (WTFC) in general are more likely to report poorer physical and mental health. Less research, however, has examined the daily implications of WTFC, such as whether individuals’ reactions to minor WTFC day-to-day (e.g. missing family dinner due to work obligation) are associated with health outcomes. We examined whether affective reactivity to daily WTFC was associated with poorer sleep, health behaviours, and mental health in a sample who may be particularly vulnerable to daily WTFC. Employed parents in the IT industry with adolescent-aged children (N = 118, Mage  = 45.01, 44.07% female) reported daily WTFC and negative affect on 8 consecutive days, in addition to completing a survey that assessed sleep, health behaviours (smoking, drinking, exercise, fast food consumption), and psychological distress. Multilevel modelling outputted individual reactivity slopes by regressing daily negative affect on the day’s WTFC. Results of general linear models indicated that affective reactivity to WTFC was associated with poorer sleep quality and higher levels of psychological distress – even when controlling for average daily negative affect on non-WTFC days. Individual differences in reactivity to daily WTFC have implications for health. Interventions aimed to reduce daily WTFC and reactivity to it are needed.
2020
Kelly E, Moen P. Fixing the Overload Problem at Work. MIT Sloan Management Review. 2020;(Reprint #61404). kelly_moen_2020_fixing_overload_at_work_-_sloan_management_review_article_1.pdf
Kelly E, Moen P. Overload: How Good Jobs Went Bad and What We Can Do about It. Princeton, New Jersey: Princeton University Press; 2020 pp. 336.Abstract

Today’s ways of working are not working—even for professionals in “good” jobs. Responding to global competition and pressure from financial markets, companies are asking employees to do more with less, even as new technologies normalize 24/7 job expectations. In Overload, Erin Kelly and Phyllis Moen document how this new intensification of work creates chronic stress, leading to burnout, attrition, and underperformance. “Flexible” work policies and corporate lip service about “work-life balance” don’t come close to fixing the problem. But this unhealthy and unsustainable situation can be changed—and Overload shows how.

Drawing on five years of research, including hundreds of interviews with employees and managers, Kelly and Moen tell the story of a major experiment that they helped design and implement at a Fortune 500 firm. The company adopted creative and practical work redesigns that gave workers more control over how and where they worked and encouraged managers to evaluate performance in new ways. The result? Employees’ health, well-being, and ability to manage their personal and work lives improved, while the company benefited from higher job satisfaction and lower turnover. And, as Kelly and Moen show, such changes can—and should—be made on a wide scale.

Complete with advice about ways that employees, managers, and corporate leaders can begin to question and fix one of today’s most serious workplace problems, Overload is an inspiring account about how rethinking and redesigning work could transform our lives and companies.

Brossoit RM, Crain TL, Hammer LB, Lee S, Bodner TE, Buxton OM. Associations among patient care workers' schedule control, sleep, job satisfaction and turnover intentions. Stress and Health. 2020;n/a (n/a). Publisher's VersionAbstract
Healthcare is the fastest growing occupational sector in America, yet patient care workers experience low job satisfaction, high turnover, and susceptibility to poor sleep compared to workers in other jobs and industries. Increasing schedule control may be one way to help mitigate these issues. Drawing from conservation of resources theory, we evaluate associations among schedule control (i.e. a contextual resource), employee sleep duration and quality (i.e. personal resources), job satisfaction, and turnover intentions. Patient care workers who reported having more schedule control at baseline reported greater sleep duration and sleep quality 6 months later, as well as higher job satisfaction and lower turnover intentions 12 months later. Workers who experienced greater sleep sufficiency (i.e. feeling well-rested) reported higher job satisfaction 6 months later, and workers who experienced fewer insomnia symptoms (i.e. trouble falling and staying asleep) reported lower turnover intentions 6 months later. The association between schedule control and job satisfaction was partially mediated by greater sleep sufficiency, though this effect was small. Providing patient care workers with greater control over their work schedules and opportunities for improved sleep may improve their job attitudes. Results were not replicated when different analytical approaches were performed, so findings should be interpreted provisionally.
2019
Kaduk A, Kelly EL, Moen P. Involuntary vs. voluntary flexible work: insights for scholars and stakeholders. Community, Work & Family. 2019;22 (4) :412-442. Publisher's VersionAbstract
ABSTRACTBuilding on insights from the early stages of our research partnership with a U.S. Fortune 500 organization, we came to differentiate between voluntary and involuntary schedule variability and remote work. This differentiation underscores the complexity behind flexible schedules and remote work, especially among white-collar, salaried professionals. We collected survey data among the partner firm's information technology (IT) workforce to evaluate whether these forms of flexibility had different implications for workers, as part of the larger Work, Family, and Health Network Study. We find that a significant minority of these employees report working variable schedules and working at home involuntarily. Involuntary variable schedules are associated with greater work-to-family conflict, stress, burnout, turnover intentions, and lower job satisfaction in models that adjust for personal characteristics, job, work hours, family demands, and other factors. Voluntary remote work, in contrast, is protective and more common in this professional sample. Employees working at least 20% of their hours at home and reporting moderate or high choice over where they work have lower stress and intentions to leave the firm. These findings point to the importance of both stakeholders and scholars distinguishing between voluntary and involuntary forms of flexibility, even in a relatively advantaged workforce.
Lee S, Lawson KM, Damaske SA. Crossover of resources and well-being within employee-partner dyads: through increased schedule control. Community, Work & Family. 2019;22 (4) :391-411. Publisher's VersionAbstract
ABSTRACTThis study examined whether one partner’s additional resources obtained from a workplace intervention influence the other partner’s perception of having those resources at home (crossover of resources). We also examined whether one partner’s decreased stress by increased work resources crosses over to the other partner’s stress levels (crossover of well-being). Longitudinal data came from IT employees and their married/cohabiting partners in midlife (N = 327). A randomized workplace intervention significantly increased employee-reported schedule control at the 6-month follow-up, which, in turn, increased partner-reported employees’ work schedule flexibility to handle family responsibilities at the 12-month follow-up. The intervention also decreased partners’ perceived stress at the 12-month follow-up through the processes by which increases in schedule control predicted decreases in employees’ perceived stress, which further predicted decreased levels of partners’ perceived stress. Notably, crossover of resources and well-being were found in couples who lived with children in the household, but not in couples without children. Our findings suggest that benefits of workplace support can permeate into the family domain, by increasing partner-perceived family resources and well-being.
Vigoureux TFD, Lee S, Buxton OM, Almeida DM. Stressor reactivity to insufficient sleep and its association with body mass index in middle-aged workers. Journal of Sleep Research. 2019;n/a (n/a) :e12955. Publisher's VersionAbstract
Summary There is evidence that insufficient sleep and more stressors are individually associated with poor metabolic health outcomes. Examining sleep and stressors jointly may account for greater variability in health outcomes; however, we know little about the combined effect of both insufficient sleep and more stressors on metabolic health. This study examined whether experiencing more stressors in response to insufficient sleep (“stressor reactivity to insufficient sleep”) was associated with body mass index in middle-aged workers. One-hundred and twenty-seven participants (Mage = 45.24 ± 6.22 years) reported nightly sleep characteristics and daily stressors on 8 consecutive days. We collected height and weight measurements to calculate body mass index (kg m−2). On average, workers reported more stressors following nights with shorter-than-usual sleep duration or poorer-than-usual sleep quality (negative slope means higher stressor reactivity to insufficient sleep). When examining stressor reactivity to insufficient sleep with insufficient sleep represented by shorter-than-usual sleep duration, compared with those with average stressor reactivity to insufficient sleep (within ±½ SD; reference), workers with high stressor reactivity to insufficient sleep (≤−½ SD) had higher body mass index (B = 3.24, p < .05). The body mass index of these workers fell in the obese range. There was no difference in body mass index between workers with low stressor reactivity to insufficient sleep (≥+½ SD) and the reference group. When examining stressor reactivity to insufficient sleep with insufficient sleep represented by poorer-than-usual sleep quality, stressor reactivity to insufficient sleep was not significantly associated with body mass index. Results suggest that middle-aged workers with higher stressor reactivity to insufficient sleep duration may be at greater risk for obesity. Results may inform future studies on interventions for improving sleep and reducing stress in middle-aged workers.
Drury T, Lee S, Buxton OM, Almeida DM. PSYCHOCOGNITIVE REACTIVITY TO INSUFFICIENT SLEEP AND ITS ASSOCIATION WITH BODY MASS. Innovation in Aging. 2019;3 (Suppl 1) :S640–S641. Publisher's VersionAbstract
Individuals tend to report more stressors on days after nights with fewer hours of sleep. There may be individual differences such that this negative sleep duration—stressor perception relationship is stronger for some than others, which may have implications for health outcomes. However, we know little about whether differences in stressor perception in response to insufficient sleep (“psychocognitive reactivity to insufficient sleep”) are associated with health outcomes such as body weight. This study examined whether psychocognitive reactivity to insufficient sleep were associated with body mass index (BMI) in midlife workers. We used a sample of 127 office workers (Mage=45.2±6.2) who participated in a daily diary study for 8 consecutive days as part of the Work, Family, and Health Study. 
      Multilevel models tested whether daily number of stressors was predicted by previous 
      nights’ sleep. We outputted within-person slopes of stressors regressed on sleep duration to predict BMI (kg/m2). Analyses adjusted for sociodemographic characteristics and mean stressors across days. On average, workers reported more stressors following nights with shorter sleep duration than usual (negative slope means higher reactivity). Compared to those with average reactivity (within ±½SD; reference), workers with higher reactivity (≤-½SD) had higher BMI (p<.05). The BMI of these workers fell in the obese range. This study is one of the first to report that middle-aged workers with higher psychocognitive reactivity to insufficient sleep may be at greater risk for obesity. Future interventions should focus on improving middle-aged workers’ sleep health to reduce next-day stressors and thereby improve their body weight.
Lee S, Buxton OM, Andel R, Almeida DM. Bidirectional associations of sleep with cognitive interference in employees' work days. Sleep Health. 2019.Abstract
OBJECTIVES: Studies have reported bidirectional associations of sleep with daily stressors and negative mood. Yet we know little about how sleep is associated with workers' daily cognitive interference, or the experience of off-task and distracting thoughts. This study examined whether nightly sleep was associated with next-day cognitive interference, and vice versa, during workdays and non-work days. DESIGN: Daily telephone interviews. SETTING: US information technology workplaces. PARTICIPANTS: 130 middle-aged employees. MEASUREMENTS: On 8 consecutive days, participants reported the frequency of experiencing off-task and distracting thoughts during the day (0 = never to 4 = very often) and multiple sleep characteristics (bedtimes, wake times, sleep duration, sleep quality, and sleep latency). Covariates included sociodemographic characteristics and work hours. RESULTS: Multilevel models revealed that, on days following earlier wake times (B = -0.32, P < .01), shorter sleep duration (B = -0.27, P < .01), or poorer sleep quality (B = -0.17, P < .01), participants reported more cognitive interference than usual. That is, waking 19 minutes earlier and sleeping 16 minutes less were associated with one additional point on the cognitive interference scale the next day. With cognitive interference predicting nightly sleep, more same day's cognitive interference was associated with earlier bedtimes (B = -0.19, P < .05) and earlier wake times (B = -0.30, P < .01) than usual. The temporal associations of nightly sleep duration and sleep quality with the following day's cognitive interference were significant on work days, but not on non-work days. CONCLUSION: Our results suggest bidirectional associations between poorer sleep and more cognitive interference, particularly on work days with implications for workday productivity and quality of life.
Kossek EE, Rosokha LM, Leana C. Work Schedule Patching in Health Care: Exploring Implementation Approaches. Work and Occupations. 2019 :0730888419841101. Publisher's VersionAbstract
The authors propose a typology of “work schedule patching,” the ongoing adjustments made to plug scheduling holes after employers post schedules. Patching occurs due to changes in employer work demands, or employee nonwork demands necessitating scheduling adjustments, which are reactive or proactive. Using qualitative data from eight health-care facilities, the authors identified three narratives justifying schedule patching implementation approaches (share-the-pain, work-life-needs, and reverse-status-rotation) with variation in formalization and improvisation. Exploratory analysis showed a suggestive link between improvised work–life scheduling and lower pressure ulcers. This article advances theory on balancing the “service triangle” of scheduling in-service economies including health care.
Lee S, Mogle JA, Jackson CL, Buxton OM. What's not fair about work keeps me up: Perceived unfairness about work impairs sleep through negative work-to-family spillover. Social Science Research. 2019. Publisher's VersionAbstract
This study examined whether perceived unfairness about work was linked to midlife workers' insomnia symptoms over time, and if the association was mediated by negative work-to-family spillover (NWFS). We used 3 waves of longitudinal data across 20 years from the Midlife in the United States Study (N = 971, Mage = 40.52). Results revealed that, wave-to-wave increases in perceived unfairness about work predicted wave-to-wave increases in NWFS over 20 years. Wave-to-wave increases in NWFS, in turn, predicted wave-to-wave increases in insomnia symptoms. Perceived unfairness about work was indirectly, but not directly associated with insomnia symptoms through NWFS. These within-person indirect mediation pathways were found after controlling for sociodemographic and family characteristics, work hours, neuroticism, physical health, and between-person associations between perceived unfairness about work, NWFS, and insomnia symptoms. These findings suggest that perceived unfairness about work may degrade workers’ sleep health over time, through the spillover of work stress to the personal domain.
DePasquale N, Crain TL, Buxton OM, Zarit SH, Almeida DM. Tonight’s Sleep Predicts Tomorrow’s Fatigue: A Daily Diary Study of Long-Term Care Employees With Nonwork Caregiving Roles. The Gerontologist. 2019 :gny176. Publisher's Version
Kossek EE, Thompson RA, Lawson KM, Bodner T, Perrigino MB, Hammer LB, Buxton OM, Almeida DM, Moen P, Hurtado DA, et al. Caring for the Elderly at Work and Home: Can a Randomized Organizational Intervention Improve Psychological Health?. J Occup Health Psychol. 2019. Publisher's VersionAbstract
Although job stress models suggest that changing the work social environment to increase job resources improves psychological health, many intervention studies have weak designs and overlook influences of family caregiving demands. We tested the effects of an organizational intervention designed to increase supervisor social support for work and nonwork roles, and job control in a results-oriented work environment on the stress and psychological distress of health care employees who care for the elderly, while simultaneously considering their own family caregiving responsibilities. Using a group-randomized organizational field trial with an intent-to-treat design, 420 caregivers in 15 intervention extended-care nursing facilities were compared with 511 caregivers in 15 control facilities at 4 measurement times: preintervention and 6, 12, and 18 months. There were no main intervention effects showing improvements in stress and psychological distress when comparing intervention with control sites. Moderation analyses indicate that the intervention was more effective in reducing stress and psychological distress for caregivers who were also caring for other family members off the job (those with elders and those "sandwiched" with both child and elder caregiving responsibilities) compared with employees without caregiving demands. These findings extend previous studies by showing that the effect of organizational interventions designed to increase job resources to improve psychological health varies according to differences in nonwork caregiving demands. This research suggests that caregivers, especially those with "double-duty" elder caregiving at home and work and "triple-duty" responsibilities, including child care, may benefit from interventions designed to increase work-nonwork social support and job control. (PsycINFO Database Record
2018
Trombley M, Bray JW, Hinde JM, Buxton OM, Johnson RC. Investigating the Negative Relationship between Wages and Obesity: New Evidence from the Work, Family, and Health Network. Nordic Journal of Health Economics. 2018. Publisher's VersionAbstract
A substantial literature has established that obesity is negatively associated with wages, particularly among females.  However, prior research has found limited evidence for the factors hypothesized to underlie the obesity wage penalty.  We add to the literature using data from IT workers at a U.S. Fortune 500 firm that provides us with direct measures of employee income and BMI, and health measures that are unavailable in national-level datasets.  Our estimates indicate that the wage-obesity penalty among females only occurs among obese mothers, and is not attributable to differences in health or human capital that may be caused by having children.
Fan W, Moen P, Kelly EL, Hammer LB, Berkman LF. Job strain, time strain, and well-being: A longitudinal, person-centered approach in two industries. Journal of Vocational Behavior. 2018. Publisher's VersionAbstract
The notion of constellations is central to many occupational health theories; empirical research is nevertheless dominated by variable-centered methodologies. Guided by the job demands-resources framework, we use a person-centered longitudinal approach to identify constellations of job demands and resources (task-based and time-based) over time that predict changes in well-being. We situate our research in two dissimilar, but growing, industries in the United States—information technology (IT) and long-term care. Drawing on data collected over 18 months, we identify five patterned, stable constellations of job demands/resources using group-based multi-trajectory modeling: (1) high strain/low hours, (2) high strain/low hours/shift work, (3) high strain/long hours, (4) active (high demands, high control) and (5) lower strain (lower demands, high control). IT workers are overrepresented in the lower-strain and active constellations, whereas long-term care providers are more often in high-strain constellations. Workers in the lower-strain constellation experience increased job satisfaction and decreased emotional exhaustion, work-family conflict and psychological distress over 18 months. In comparison, workers in high-strain job constellations fare worse on these outcomes, as do those in the active constellation. Industrial contexts matter, however: Compared with long-term care workers, IT workers' well-being is more at risk when working in the “high strain/long hours” constellation. As the labor market continues to experience structural changes, scholars and policy makers need to attend to redesigning the ecological contexts of work conditions to promote workers' well-being while taking into account industrial differences.
Lawson KM, Lee S. Better previous night sleep is associated with less next day work-to-family conflict mediated by higher work performance among female nursing home workers. Sleep Health. 2018. Publisher's VersionAbstract
Objectives Cross-sectional research has found that shorter and poorer sleep are associated with lower work performance and greater work-to-family conflict (WTFC). However, we know little about daily mechanisms linking sleep, work performance, and WTFC. This study tested whether previous nights' sleep was linked to next day WTFC, mediated by work performance. Design Daily interview methodology. Setting US extended-care workplaces. Participants One hundred seventy-one female employees with children aged 9 to 17 years. Measurements In telephone interviews on 8 consecutive evenings, participants reported their daily work performance (work productivity, work quality), WTFC (e.g., “how much did things you wanted to do at home not get done because of the demands your job put on you?”), and previous nights' sleep duration (in hours) and sleep quality (1 = very badl

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