Evaluating cardiometabolic and sleep health benefits of a workplace intervention

描述（由申请人提供）：在美国，管理工作和家庭责任通常是困难的，并且会影响员工、他们的家庭和工作场所的健康和福祉。尽管近年来工作-生活政策在美国工作场所的普及程度急剧上升，但很少有纵向研究使用实验设计来评估特定的工作-家庭干预对工作-家庭冲突和工人健康结果的影响。为了解决支持工作家庭政策的知识库中的这一关键缺口，美国国立卫生研究院（NIH）和疾病控制与预防中心（CDC）成立了工作、家庭和健康网络（WFHN）。经过3年由美国国立卫生研究院和美国疾病控制与预防中心资助的试点和形成性研究，工作、家庭和健康网络开始了一项重大（3100万美元）的研究，在工作场所（30个地点）、工作组（每个工作地点约7个）、员工（n=1500）和员工家庭层面的多层次框架中评估特定行为工作场所干预的效果。本母项目评估了一项创新的工作场所干预措施，旨在减少长期医疗保健行业中直接照顾病人的员工在健康方面，特别是心脏代谢和睡眠健康方面的工作与家庭冲突。这种干预的目的是减少员工的工作家庭冲突，但有可能增加组织对中层管理人员工作家庭需求的支持，这些管理人员在一线处理日常工作生活和监督员工，从而改善这些管理人员的健康状况。在这项辅助研究计划中，我们建议在2010年至2013年期间对28个工作场所的管理人员（n=163）进行研究。我们建议对中层管理人员的心脏代谢和睡眠健康进行评估，使用与员工的父母研究评估相同的措施。具体来说，我们假设1)有效的工作场所干预关注于经理实践和员工授权将最终减少经理的压力，我们将其操作为降低心脏代谢疾病风险和增加经理睡眠时间（干预后随访6个月，12个月，18个月）；2)在6个月、12个月和18个月的随访中，工作场所干预对直接测量的管理者健康（心脏代谢疾病风险和睡眠）的影响将与员工直接测量的健康（心脏代谢疾病风险和睡眠）相关。为了验证这些假设，我们还将开发新颖且广泛适用的变量选择统计方法，使用惩罚似然方法在存在缺失数据的纵向研究中识别结果的预测因子。我们扩展了父母研究的概念框架，包括管理者层面的客观健康措施，这些措施能够评估工作场所干预对管理者健康结果的影响，而不是持续的常规做法。这一建议为研究影响工作场所健康和慢性心脏代谢疾病风险的多层次因素提供了一个独特的、具有时代性的机会。

DESCRIPTION (provided by applicant): Managing work and family responsibilities in the U.S. is often difficult and impacts the health and well-being of employees, their families, and the workplace. Although the prevalence of work-life policies in U.S. workplaces has increased dramatically in recent years, there are few longitudinal studies using experimental designs to evaluate the effects of specific work-family interventions on work-family conflict and worker health outcomes. To address this critical gap in the knowledge base supporting work-family policies, the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC) formed the Work, Family, and Health Network (WFHN). After 3 years of NIH- and CDC-funded pilot and formative research, the Work, Family and Health Network has embarked on a major ($31M) study of the effects of a specific behavioral workplace intervention evaluated in a multi-level framework at the workplace (30 sites), work group (~ 7 per worksite), employee (n=1500), and employee family levels. This parent project evaluates an innovative workplace intervention designed to reduce work-family conflict on the health, particularly cardiometabolic and sleep health, of direct patient-care employees in the long-term health care industry. This intervention is designed to decrease work-family conflict for employees, but has the potential of increasing the organizational support for the work-family needs of mid-level managers-those supervisors in the trenches who deal with the day to day work life and supervision of employees-leading to improved health of these managers. In this ancillary study proposal, we propose to study managers (n=163) at 28 worksites in parallel with the parent study data collection from 2010 through 2013. We propose to assess mid-level managers' cardiometabolic and sleep health using measures identical to the parent study assessments in employees. Specifically, we hypothesize that 1) an effective workplace intervention focused on manager practices and employee empowerment will ultimately reduce manager stress, which we operationalize as decreased cardiometabolic disease risk and increased manager sleep duration (at 6-, 12-, 18-month follow-ups post-intervention); and 2) that the effects of the workplace intervention on directly-measured managers health (cardiometabolic disease risk and sleep) will be associated with employees' directly-measured health (cardiometabolic disease risk and sleep) at the 6-, 12, 18-month follow-ups. To test these hypotheses we will also develop novel and broadly applicable statistical methodologies for variable selection to identify predictors of the outcomes in longitudinal studies in the presence of missing data, using a penalized likelihood approach. We extend the conceptual framework of the parent study by including manager-level objective health measures that enable the evaluation of the effects of the workplace intervention, versus continued usual practice, on manager health outcomes. This proposal represents a unique and time-sensitive opportunity to study the multi-level factors influencing health and chronic cardiometabolic disease risk in the workplace.