Longitudinal Trajectories of Workplace Violence and Worker Health Among Child Protective Services Workers

摘要 工作场所暴力，或针对工人的言语辱骂或身体暴力的行为或威胁 这一现象十分猖獗，对卫生和社会援助部门的工作人员有害。估计数 表明这些工人中有62%到97%在他们的职业生涯中经历过暴力。此外，该地区的暴力事件 该部门在过去十年中有所上升，在冠状病毒大流行期间的明显激增构成了 “国际紧急情况”破坏了卫生系统。工作场所暴力造成的人员伤亡和经济损失 包括身体伤害、心理疾病、生产力下降和服务质量下降等高风险。工人在 该部门的非致命性工伤发生率是所有美国工人的5倍(10.4比2.1/10,000 工人)，占美国工伤事故的73%。该部门的一个组织--儿童保护服务 (CPS)工作人员，负责调查并向据称或证实有子女的家庭提供服务 虐待或疏忽，特别容易受到暴力，特别是施暴者实施的客户暴力 在接受客户服务时变得暴力。CPS工作的性质(例如，驱逐儿童的威胁、敌对的 客户、危险社区)将工人置于独特且易发生暴力的环境中。总目标 该项目的目的是检查以下人群中当事人暴力的纵向流行率和健康后果 CPS工人。具体地说，本研究的目的是(1)确定当事人暴力的三年纵向轨迹 按子类型(例如，言语虐待、威胁、身体)；(2)测试客户暴力在预测员工健康方面的作用 随着时间的推移；以及(3)确定当事人的暴力轨迹以及工作需求和支持的程度 相互作用，影响工人的健康轨迹。我们将使用佛罗里达州专业人士研究的数据来 安全家庭(FSPSF)，这是一项针对CPS工人(N=1500)的全州纵向队列研究，我们收集了 提供对CPS工作和员工福利的洞察。这个项目意义重大，因为它响应了 NIOSH(2019)的战略目标1，通过跟踪与工作相关的伤害和疾病并产生知识来 告知干预策略。此外，还分析了工人属性；工作需求和支持；暴力类型 和积累；以及健康后果通过以下方式解决Nora(2019)研究议程目标3 审查工作场所暴力的流行病学，并确定预防和缓解战略。这个 该项目通过纵向研究客户暴力和员工健康来提供概念创新 CPS员工在工作的前三年、人员流失率最高和风险增加的时间段 暴力。我们使用高级统计纵向建模来提供更有力的解释证据 目前研究中没有确定的路径在方法上是创新的。地震的频率和强度 卫生和社会援助部门中的客户暴力及其在工人健康方面的潜在作用放大了 需要审查暴力及其在工人任期内的积累，以及对工人健康的影响。

Abstract Workplace violence, or the act or threat of verbal abuse or physical violence directed toward workers completing their jobs, is rampant and harmful to workers in the health and social assistance sector. Estimates suggest that 62% to 97% of these workers experience violence in their careers. Moreover, violence in the sector has risen over the last decade, and, an apparent surge during the Coronavirus pandemic poses an “international emergency” undermining health systems. The human and economic tolls of workplace violence are high including physical injury, psychological illness, lost productivity, and lower service quality. Workers in this sector have a non-fatal workplace injury rate 5 times that of all U.S. workers (10.4 vs. 2.1 per 10,000 workers) and account for 73% of U.S. workplace injuries. One group in this sector, Child Protective Services (CPS) workers, responsible for investigating and providing services to families with alleged or verified child abuse or neglect, are particularly vulnerable to violence, specifically client violence in which the perpetrator becomes violent while receiving client services. The nature of CPS work (e.g., threat of child removal, hostile clients, dangerous neighborhoods) places workers in unique and violent-prone environments. The overall goal of this project is to examine the longitudinal prevalence and health consequences of client violence among CPS workers. Specifically, this study aims to (1) determine the 3-year longitudinal trajectories of client violence by subtype (i.e., verbal abuse, threat, physical); (2) test the role of client violence in predicting worker health over time; and (3) determine the extent to which client violence trajectories and job demands and supports interact to influence workers’ health trajectories. We will use data from the Florida Study of Professionals for Safe Families (FSPSF), a statewide, longitudinal cohort study of CPS workers (N = 1,500) that we collected to provide insight into CPS work and worker wellbeing. This project is significant because it responds to NIOSH’s (2019) Strategic Goal 1 by tracking work-related injuries and illnesses and generating knowledge to inform intervention strategies. Moreover, analyzing worker attributes; job demands and supports; violence type and accumulation; and health consequences addresses NORA’s (2019) Research Agenda Objective 3 by examining the epidemiology of workplace violence and identifying strategies for prevention and mitigation. The project offers conceptual innovation by examining client violence and worker health longitudinally among a cohort of CPS workers over the first three years on the job, the time of highest turnover and increased risk of violence. Our use of advanced statistical longitudinal modeling to provide stronger evidence of explanatory pathways not determined in current research is methodologically innovative. The frequency and intensity of client violence among the health and social assistance sector and its potential role in worker health amplify the need to examine violence, its accumulation over worker tenure, and the consequences for worker health.