Publications

Abstract We analyzed qualitative and quantitative data from U.S.-based employees in 30 long-term care facilities. Analysis of semi-structured interviews from 154 managers informed quantitative analyses. Quantitative data include 1214 employees' scoring of their supervisors and their organizations on family supportiveness (individual scores and aggregated to facility level), and three outcomes: (1), care quality indicators assessed at facility level (n = 30) and collected monthly for six months after employees' data collection; (2), employees' dichotomous survey response on having additional off-site jobs; and (3), proportion of employees with additional jobs at each facility. Thematic analyses revealed that managers operate within the constraints of an industry that simultaneously: (a) employs low-wage employees with multiple work-family challenges, and (b) has firmly institutionalized goals of prioritizing quality of care and minimizing labor costs. Managers universally described providing work-family support and prioritizing care quality as antithetical to each other. Concerns surfaced that family-supportiveness encouraged employees to work additional jobs off-site, compromising care quality. Multivariable linear regression analysis of facility-level data revealed that higher family-supportive supervision was associated with significant decreases in residents' incidence of all pressure ulcers (−2.62%) and other injuries (−9.79%). Higher family-supportive organizational climate was associated with significant decreases in all falls (−17.94%) and falls with injuries (−7.57%). Managers' concerns about additional jobs were not entirely unwarranted: multivariable logistic regression of employee-level data revealed that among employees with children, having family-supportive supervision was associated with significantly higher likelihood of additional off-site jobs (RR 1.46, 95%CI 1.08–1.99), but family-supportive organizational climate was associated with lower likelihood (RR 0.76, 95%CI 0.59–0.99). However, proportion of workers with additional off-site jobs did not significantly predict care quality at facility levels. Although managers perceived providing work-family support and ensuring high care quality as conflicting goals, results suggest that family-supportiveness is associated with better care quality.

Although work schedulers serve an organizational role influencing decisions about balancing conflicting stakeholder interests over schedules and staffing, scheduling has primarily been described as an objective activity or individual job characteristic. The authors use the lens of job crafting to examine how schedulers in 26 health care facilities enact their roles as they “fill holes” to schedule workers. Qualitative analysis of interview data suggests that schedulers expand their formal scope and influence to meet their interpretations of how to manage stakeholders (employers, workers, and patients). The authors analyze variations in the extent of job crafting (cognitive, physical, relational) to broaden role repertoires. They find evidence that some schedulers engage in rule-bound interpretation to avoid role expansion. They also identify four types of schedulers: enforcers, patient-focused schedulers, employee-focused schedulers, and balancers. The article adds to the job-crafting literature by showing that job crafting is conducted not only to create meaningful work but also to manage conflicting demands and to mediate among the competing labor interests of workers, clients, and employers.

Considerable evidence documents linkages between parental knowledge of youth activities and youth risky behavior. We extended this research to determine whether parental knowledge was associated with youth physical health, including reports of physical symptoms (e.g., headaches, stomachaches) and a biomarker of hypothalamic pituitary adrenocortical (HPA) axis functioning (i.e., salivary cortisol levels). Participants were children of employees in the Information Technology division of a Fortune 500 company (N = 132, mean age youth = 13.39 years, 55% female) who participated in a daily diary study. Data were collected via telephone calls on 8 consecutive evenings. On 4 study days, cortisol samples were collected at 4 time points (waking, 30 min after waking, before dinner, bedtime). Multilevel models revealed that, at the between-person level, youth whose parents had higher average knowledge about their activities, exhibited lower bedtime cortisol levels. Furthermore, at the within-person level, on days when parents displayed more knowledge than usual (relative to their own 8-day average), youth had lower before-dinner cortisol than usual. Linkages between average parental knowledge and physical health symptoms were moderated by youth age: Younger but not older adolescents whose parents were more knowledgeable had fewer physical health symptoms, on average. A next step is to identify the processes that underlie these associations. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

Using a group-randomized field experimental design, this study tested whether a workplace intervention—designed to reduce work–family conflict—buffered against potential age-related decreases in the affective well-being of employees’ children. Daily diary data were collected from 9- to 17-year-old children of parents working in an information technology division of a U.S. Fortune 500 company prior to and 12 months after the implementation of the Support-Transform-Achieve-Results (STAR) workplace intervention. Youth (62 with parents in the STAR group, 41 in the usual-practice group) participated in 8 consecutive nightly phone calls, during which they reported on their daily stressors and affect. Well-being was indexed by positive and negative affect and affective reactivity to daily stressful events. The randomized workplace intervention increased youth positive affect and buffered youth from age-related increases in negative affect and affective reactivity to daily stressors. Future research should test specific conditions of parents’ work that may penetrate family life and affect youth well-being. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

This study tests a central theoretical assumption of stress process and job strain models, namely that increases in employees’ control and support at work should promote well-being. To do so, we use a group-randomized field trial with longitudinal data from 867 information technology (IT) workers to investigate the well-being effects of STAR, an organizational intervention designed to promote greater employee control over work time and greater supervisor support for workers’ personal lives. We also offer a unique analysis of an unexpected field effect—a company merger—among workers surveyed earlier versus later in the study period, before or after the merger announcement. We find few STAR effects for the latter group, but over 12 months, STAR reduced burnout, perceived stress, and psychological distress, and increased job satisfaction, for the early survey group. STAR effects are partially mediated by increases in schedule control and declines in family-to-work conflict and burnout (an outcome and mediator) by six months. Moderating effects show that STAR benefits women in reducing psychological distress and perceived stress, and increases non-supervisory employees’ job satisfaction. This study demonstrates, with a rigorous design, that organizational-level initiatives can promote employee well-being.

Objectives Qualitative studies have highlighted the possibility of job loss following occupational injuries for some workers, but prospective investigations are scant. We used a sample of nursing home workers from the Work, Family and Health Network to prospectively investigate association between occupational injuries and job loss.

Methods We merged data on 1331 workers assessed 4 times over an 18-month period with administrative data that include job loss from employers and publicly available data on their workplaces. Workers self-reported occupational injuries in surveys. Multivariable logistic regression models estimated risk ratios for the impact of occupational injuries on overall job loss, whereas multinomial models were used to estimate OR of voluntary and involuntary job loss. Use of marginal structural models allowed for adjustments of multilevel lists of confounders that may be time varying and/or on the causal pathway.

Results By 12 months, 30.3% of workers experienced occupational injury, whereas 24.2% experienced job loss by 18 months. Comparing workers who reported occupational injuries to those reporting no injuries, risk ratio of overall job loss within the subsequent 6 months was 1.31 (95% CI 0.93 to 1.86). Comparing the same groups, injured workers had higher odds of experiencing involuntary job loss (OR 2.19; 95% CI 1.27 to 3.77). Also, compared with uninjured workers, those injured more than once had higher odds of voluntary job loss (OR 1.95; 95% CI 1.03 to 3.67), while those injured once had higher odds of involuntary job loss (OR 2.19; 95% CI 1.18 to 4.05).

Conclusions Despite regulatory protections, occupational injuries were associated with increased risk of voluntary and involuntary job loss for nursing home workers.

This study examined feelings of having enough time (i.e., perceived time adequacy) in a sample of employed parents (N = 880) in information technology and extended-care industries. Adapting a person-centered latent profile approach, we identified 3 profiles of perceived time adequacy for paid work, parenting, and partner roles: family time protected, family time sacrificed, and time balanced. Drawing upon the conservation of resources theory (Hobfòll, 1989), we examined the associations of stressors and resources with the time adequacy profiles. Parents in the family time sacrificed profile were more likely to be younger, women, have younger children, work in the extended-care industry, and have nonstandard work schedules compared to those in the family time protected profile. Results from multinomial logistic regression analyses revealed that, with the time balanced profile as the reference group, having fewer stressors and more resources in the family context (less parent-child conflict and more partner support), work context (longer company tenure, higher schedule control and job satisfaction), and work-family interface (lower work-to-family conflict) was linked to a higher probability of membership in the family time protected profile. By contrast, having more stressors and fewer resources, in the forms of less partner support and higher work-to-family conflict, predicted a higher likelihood of being in the family time sacrificed profile. Our findings suggest that low work-to-family conflict is the most critical predictor of membership in the family time protected profile, whereas lack of partner support is the most important factor to be included in the family time sacrificed profile.

The purpose of this paper is to examine the ways in which leaders influence follower’s work-life management. Specifically, the authors propose that personal (positive affect), social (managerial support for work-family balance), and job (autonomy) resources mediate the relationships between transformational leadership and work-family conflict (WFC) and enrichment.

An increasing number of adults, both men and women, are simultaneously managing work and family caregiving roles. Guided by the stress process model, we investigate whether 823 employees occupying diverse family caregiving roles (child caregiving only, elder caregiving only, and both child caregiving and elder caregiving, or “sandwiched” caregiving) and their noncaregiving counterparts in the information technology division of a white-collar organization differ on several indicators of psychosocial stress along with gender differences in stress exposure. Compared with noncaregivers, child caregivers reported more perceived stress and partner strain whereas elder caregivers reported greater perceived stress and psychological distress. With the exception of work-to-family conflict, sandwiched caregivers reported poorer overall psychosocial functioning. Additionally, sandwiched women reported more family-to-work conflict and less partner support than their male counterparts. Further research on the implications of combining a white-collar employment role with different family caregiving roles is warranted.

OBJECTIVE: To estimate the return on investment (ROI) of a workplace initiative to reduce work-family conflict in a group-randomized 18-month field experiment in an information technology firm in the United States.
METHODS: Intervention resources were micro-costed; benefits included medical costs, productivity (presenteeism), and turnover. Regression models were used to estimate the ROI, and cluster-robust bootstrap was used to calculate its confidence interval.
RESULTS: For each participant, model-adjusted costs of the intervention were $690 and company savings were $1850 (2011 prices). The ROI was 1.68 (95% confidence interval, -8.85 to 9.47) and was robust in sensitivity analyses.
CONCLUSION: The positive ROI indicates that employers' investment in an intervention to reduce work-family conflict can enhance their business. Although this was the first study to present a confidence interval for the ROI, results are comparable with the literature.

There are extensive literatures on work conditions and health and on family contexts and health, but less research asking how a spouse or partners' work conditions may affect health behaviors. Drawing on the constrained choices framework, we theorized health behaviors as a product of one's own time and spouses' work time as well as gender expectations. We examined fast food consumption and exercise behaviors using survey data from 429 employees in an Information Technology (IT) division of a U.S. Fortune 500 firm and from their spouses. We found fast food consumption is affected by men's work hours-both male employees' own work hours and the hours worked by husbands of women respondents-in a nonlinear way. The groups most likely to eat fast food are men working 50 h/week and women whose husbands work 45-50 h/week. Second, exercise is better explained if work time is conceptualized at the couple, rather than individual, level. In particular, neo-traditional arrangements (where husbands work longer than their wives) constrain women's ability to engage in exercise but increase odds of men exercising. Women in couples where both partners are working long hours have the highest odds of exercise. In addition, women working long hours with high schedule control are more apt to exercise and men working long hours whose wives have high schedule flexibility are as well. Our findings suggest different health behaviors may have distinct antecedents but gendered work-family expectations shape time allocations in ways that promote men's and constrain women's health behaviors. They also suggest the need to expand the constrained choices framework to recognize that long hours may encourage exercise if both partners are looking to sustain long work hours and that work resources, specifically schedule control, of one partner may expand the choices of the other.

In this paper, we describe the methods used for the successful implementation of a longitudinal survey in a workplace setting. Data for the Work, Family & Health Study (WFHS) were collected at baseline and 6, 12, and 18 months post-baseline, and consisted of computer-assisted interviews, basic health measures, dried blood spot collection, and collection of sleep data via an actigraph watch. Data collection in the workplace presents unique logistical and operational challenges. Based on our experience, we discuss these challenges and offer key suggestions for successfully planning and implementing in-person data collection in a workplace setting.

Using a daily diary design, the current study assessed within-person associations of work-to-family conflict with negative affect and salivary cortisol. Furthermore, the authors investigated whether supervisor support moderated these associations. Over 8 consecutive days, 131 working parents employed by an information technology company answered telephone interviews about stressors and mood that occurred in the previous 24 hours. On Days 2–4 of the study protocol, they also provided 5 saliva samples throughout the day that were assayed for cortisol. Results indicated a high degree of day-to-day fluctuation in work-to-family conflict, with employed parents having greater negative affect and poorer cortisol regulation on days with higher work-to-family conflict compared to days when they experience lower work-to-family conflict. These associations were buffered, however, when individuals had supervisors who offered support. Discussion centers on the use of dynamic assessments of work-to-family conflict and employee well-being.

We tested the effects of a work–family intervention on employee reports of safety compliance and organizational citizenship behaviors in 30 health care facilities using a group-randomized trial. Based on conservation of resources theory and the work–home resources model, we hypothesized that implementing a work–family intervention aimed at increasing contextual resources via supervisor support for work and family, and employee control over work time, would lead to improved personal resources and increased employee performance on the job in the form of self-reported safety compliance and organizational citizenship behaviors. Multilevel analyses used survey data from 1,524 employees at baseline and at 6-month and 12-month postintervention follow-ups. Significant intervention effects were observed for safety compliance at the 6-month, and organizational citizenship behaviors at the 12-month, follow-ups. More specifically, results demonstrate that the intervention protected against declines in employee self-reported safety compliance and organizational citizenship behaviors compared with employees in the control facilities. The hypothesized mediators of perceptions of family-supportive supervisor behaviors, control over work time, and work–family conflict (work-to-family conflict, family-to-work conflict) were not significantly improved by the intervention. However, baseline perceptions of family-supportive supervisor behaviors, control over work time, and work–family climate were significant moderators of the intervention effect on the self-reported safety compliance and organizational citizenship behavior outcomes. (PsycINFO Database Record (c) 2015 APA, all rights reserved)

Purpose of the Study: This study examines how certified nursing assistants (CNAs) balancing family caregiving roles—child care (double-duty child caregivers), elder care (double-duty elder caregivers), and both child and elder care (triple-duty caregivers)—utilize health care services relative to nonfamily caregiving counterparts (formal-only caregivers).Design and Methods: A sample of 884 CNAs from the Work, Family and Health Study was drawn on to assess the number of acute care (i.e., emergency room or urgent care facility) and other health care (i.e., outpatient treatment or counseling) visits made during the past 6 months.Results: Double-duty elder and triple-duty caregivers had higher acute care utilization rates than formal-only caregivers. CNAs with and without family caregiving roles had similar rates of other health care visits.Implications: CNAs providing informal care for older adults have higher acute care visit rates. Given the increasing need for family caregivers and the vital importance of the health of the nursing workforce for the health of others, future research on how double- and triple-duty caregivers maintain their health amidst constant caregiving should be a priority.

This study tested whether effects of a workplace intervention, aimed at promoting employees’ schedule control and supervisor support for personal and family life, had implications for parent–adolescent relationships; we also tested whether parent–child relationships differed as a function of how many intervention program sessions participants attended. Data came from a group randomized trial of a workplace intervention, delivered in the information technology division of a Fortune 500 company. Analyses focused on 125 parent–adolescent dyads that completed baseline and 12-month follow-up home interviews. Results revealed no main effects of the intervention, but children of employees who attended 75 % or more program sessions reported more time with their parent and more parent education involvement compared to adolescents whose parents attended <75 % of sessions, and they tended to report more time with parent and more parental solicitation of information about their experiences compared to adolescents whose parents were randomly assigned to the usual practice condition.

Purpose
The implications of sleep patterns for adolescent health are well established, but we know less about larger contextual influences on youth sleep. We focused on parents' workplace experiences as extrafamilial forces that may affect youth sleep.
Methods
In a group-randomized trial focused on employee work groups in the information technology division of a Fortune 500 company, we tested whether a workplace intervention improved sleep latency, duration, night-to-night variability in duration, and quality of sleep of employees' offspring, aged 9–17 years. The intervention was aimed at promoting employees' schedule control and supervisor support for personal and family life to decrease employees' work–family conflict and thereby promote the health of employees, their families, and the work organization. Analyses focused on 93 parent–adolescent dyads (57 dyads in the intervention and 46 in the comparison group) that completed baseline and 12-month follow-up home interviews and a series of telephone diary interviews that were conducted on eight consecutive evenings at each wave.
Results
Intent-to-treat analyses of the diary interview data revealed main effects of the intervention on youth's sleep latency, night-to-night variability in sleep duration, and sleep quality, but not sleep duration.
Conclusions

The intervention focused on parents' work conditions, not on their parenting or parent–child relationships, attesting to the role of larger contextual influences on youth sleep and the importance of parents' work experiences in the health of their children.

We investigated associations of work–family conflict and work and family conditions with objectively measured cardiometabolic risk and sleep. Multilevel analyses assessed cross-sectional associations between employee and job characteristics and health in analyses of 1,524 employees in 30 extended-care facilities in a single company. We examined work and family conditions in relation to: (a) validated, cardiometabolic risk score based on measured blood pressure, cholesterol, glycosylated hemoglobin, body mass index, and self-reported tobacco consumption and (b) wrist actigraphy–based sleep duration. In fully adjusted multilevel models, work-to-family conflict but not family-to-work conflict was positively associated with cardiometabolic risk. Having a lower level occupation (nursing assistant vs. nurse) was associated with increased cardiometabolic risk, whereas being married and having younger children at home was protective. A significant Age × Work-to-Family Conflict interaction revealed that higher work-to-family conflict was more strongly associated with increased cardiometabolic risk in younger employees. High family-to-work conflict was significantly associated with shorter sleep duration. Working long hours and having children at home were both independently associated with shorter sleep duration. High work-to-family conflict was associated with longer sleep duration. These results indicate that different dimensions of work–family conflict may pose threats to cardiometabolic health and sleep duration for employees. This study contributes to the research on work–family conflict, suggesting that work-to-family and family-to-work conflict are associated with specific health outcomes. Translating theory and findings to preventive interventions entails recognition of the dimensionality of work and family dynamics and the need to target specific work and family conditions.