Longitudinal measurement of work stressors in pregnancy

描述(由申请人提供)：有证据表明，由于工作场所的心理社会压力，某些群体的怀孕工人可能面临早产或小于胎龄(SGA)分娩的风险。职业压力和不良妊娠结局之间的明确联系一直很难得出。包括研究设计、暴露的回顾评估和暴露测量的选择在内的因素可能部分地掩盖了工作压力和妊娠结局之间的任何联系。这项拟议的发展和规划赠款的总体目标是获得初步数据，评估怀孕期间职业压力的两种模式，特别是在怀孕期间重复和纵向测量，以评估这些压力在怀孕期间可能发生变化的可能性。这项建议还旨在评估努力-回报不平衡(ERI)模型的使用，该模型尚未在怀孕工人身上进行测试，也未用于怀孕结局的研究。利用200名怀孕的职业女性的样本，这项研究提出了在怀孕期间重复的、纵向的职业压力测量方法。这项研究的主要目的是：1)探索使用新的工具测量孕妇的职业心理社会应激源；特别是使用努力-回报不平衡(ERI)模型，并与需求-控制(DC)模型进行比较，并可能结合其特点。2)评价ERI在孕期的心理测量学特性，包括信度和内容效度。3)评价应激量表的结构效度，使其能够用于测量孕期的职业心理社会紧张。4)评估职业女性的职业心理社会应激源水平在以怀孕为代表的独特时期内发生变化的可能性，评估这种变化的方向和程度。将使用重复测量和分层数据的统计方法来检查职业压力源的轨迹以及其他个人水平因素可能对其进行的修正。这里提出的工作代表了测试这些假设影响的能力的必要的第一步，并将有助于确定工作场所压力的心理社会参数的新模型是否有助于衡量与不良妊娠结果的关联。此外，这项工作将代表对怀孕期间是否发生压力测量参数的变化或随时间变化的不同轨迹的初步评估。一旦实现了这些目标，由此产生的暴露测量结果就可以用于正在进行的研究中，以识别和瞄准可能与不良出生结果相关的特定类型的工作。在此提出的探索性工作主要涉及NARA的优先事项，主要是在怀孕和生育异常领域，以及在试验用于描述工作安排的较新工具方面，并通过侧重于特定的分组，可能加强对处于危险中的特殊人群的了解。

DESCRIPTION (provided by applicant): Evidence suggests that some groups of pregnant workers may be at risk for premature delivery or small-for-gestational age (SGA) births as a consequence of workplace psychosocial stressors. Clear associations between occupational stressors and adverse pregnancy outcomes have been difficult to draw. Factors including study design, retrospective assessment of exposure, and choice of exposure measurement may be partially obscuring any association between work-related stress and pregnancy outcomes. The overall goals of this proposed developmental and planning grant are to obtain preliminary data assessing two models of occupational stress during pregnancy, in particular measuring repeatedly and longitudinally across the course of pregnancy to evaluate the possibility that these may change across pregnancy. This proposal aims also to evaluate the use of the effort-reward imbalance (ERI) model, which has not been tested in pregnant workers or used in studies of pregnancy outcomes. Using a sample of 200 pregnant working women, this study proposes repeated, longitudinal measures of occupational stress across the course of pregnancy. Principal aims of the study are: 1) To explore the use of newer instruments measuring occupational psychosocial stressors in pregnant women; specifically using the Effort-Reward Imbalance (ERI) model, with comparison to, and possible combination of features with, the Demand-Control (DC) model. 2) To evaluate the psychometric properties of the ERI in pregnancy, including reliability, and content validity. 3) To evaluate the construct validity of the stress scales, to enable their use in measuring occupational psychosocial strain in pregnancy. 4) To evaluate the possibility that occupational psychosocial stressor levels in working women change across the unique time period represented by pregnancy, assessing the direction and magnitude of this change. Statistical methods for repeated-measures and hierarchical data will be used to examine trajectories of occupational stressors as well as their possible modification by other individual-level factors. The work proposed here represents a necessary first step in the ability to test these hypothesized effects, and will assist in determining whether newer models of the psychosocial parameters of stress in the workplace might be useful in measuring an association with adverse pregnancy outcomes. As well, this work will represent an initial assessment of whether changes in measured parameters of stress, or distinct trajectories over time, occur during the course of pregnancy. Once these aims are accomplished, the resultant exposure measurements can be used in ongoing studies to recognize and target particular types of work that may be associated with adverse birth outcomes. The exploratory work proposed here addresses NORA priorities, principally in the area of pregnancy and fertility abnormalities, as well as in piloting newer tools for describing the organization of work, and, through its focus on a particular subgroup, may enhance understanding of special populations at risk.