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

摘要 工作场所暴力，或针对工人的口头虐待或身体暴力的行为或威胁 在卫生和社会援助部门，强迫劳动者完成工作的现象十分普遍，对工作人员有害。估计 62%至97%的工人在职业生涯中经历过暴力。此外， 该行业在过去十年中有所上升，而且，在冠状病毒大流行期间的明显激增构成了一个 “国际紧急情况”破坏卫生系统。工作场所暴力造成的人员和经济损失 包括身体伤害、心理疾病、生产力损失和服务质量下降。工人 该行业的非致命工伤率是美国所有工人的5倍（每10，000人中有10.4人对2.1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，负责调查据称或经核实有子女的家庭并向其提供服务 虐待或忽视，特别容易受到暴力，特别是客户暴力，其中肇事者 在接受客户服务时变得暴力。CPS工作的性质（例如，威胁要带走孩子，怀有敌意 客户，危险的社区）将工人置于独特和暴力倾向的环境中。总目标 该项目的主要目的是研究在2000年至2005年期间， CPS员工具体而言，本研究旨在（1）确定客户暴力的3年纵向轨迹 通过子类型（即，口头虐待，威胁，身体）;（2）测试客户暴力在预测工人健康方面的作用 随着时间的推移;以及（3）确定客户暴力轨迹和工作需求和支持的程度 影响工人的健康轨迹。我们将使用来自佛罗里达专业人士研究的数据， 安全家庭（FSPSF），一项全州范围的CPS工作者纵向队列研究（N = 1，500），我们收集了这些数据， 深入了解CPS工作和工人福利。这个项目意义重大，因为它响应了 NIOSH（2019）战略目标1通过跟踪与工作有关的伤害和疾病，并产生知识， 知情干预战略。此外，还分析了劳动者属性、工作需求与支持、暴力类型 和积累;和健康后果解决了诺拉（2019年）的研究议程目标3， 研究工作场所暴力的流行病学，并确定预防和减轻暴力的战略。的 该项目提供了概念创新，通过纵向研究客户暴力和工人健康， CPS工人在工作的头三年，最高流动率和风险增加的时间， 暴力我们使用先进的统计纵向模型，以提供更有力的证据，解释 目前研究中未确定的途径是方法上的创新。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， 需要审查暴力、其在工人任期内的累积以及对工人健康的后果。

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.