Harvard Center for Excellence to Promote a Healthier Workforce

描述（由申请人提供）：“哈佛卓越中心促进更健康的劳动力”：项目A -“改善卫生保健工作者健康和安全的综合方法：拟议修订，纳入健康的客观生理标志”（竞争修订）。该子研究的目的是通过客观的健康生物标志物来增强现有的研究设计。目前，这项探索工作相关暴露与健康结果之间关系的研究使用两种方法来评估工人的健康结果：自我报告的健康指标（例如，诸如下背痛残疾和慢性病的构造）和雇员记录数据（例如，工人赔偿要求，工伤报告）。在这一竞争性修订中，我们建议增加客观的健康指标，这些指标是疾病风险的临床标志物。增加客观健康措施大大加强了利用主观措施和行政工作场所数据制定的总体概念框架。目前的研究建议评估中介机制之间的关系（例如，工作中的身体和心理社会暴露、社会规范和社会支持），改变条件（例如，社会经济地位、种族/民族、性别、管理态度），近端结果（例如，疲劳，工作满意度），和自我报告的工人健康结果（例如，下背痛残疾，健康行为），通过随机子样本（n=1200）的病人护理工作者的调查。此外，组织的政策和计划和选定的工人健康结果的关系将进行调查。我们现在建议评估客观的工人健康结果，包括血液生物标志物（CHD风险，包括糖尿病风险，慢性炎症和应激介导的免疫抑制），生命体征，身高/体重/腰围在一个子集的调查工人。拟议的竞争性修订增加了工人健康结果的重要客观衡量标准，这不是当前研究的一部分。收集这些客观指标还可以使我们通过工作，家庭和健康网络将研究结果与NIOSH/NIH资助的相关研究进行比较。

DESCRIPTION (provided by applicant): "Harvard Center of Excellence to Promote a Healthier Workforce": Project A - "Integrated approaches to improving the health and safety of health care workers: Proposed Revision to incorporate objective physiologic markers of health" (Competitive Revision). The goal of this sub-study is to augment the existing study design with objective health biomarkers. Currently, this study exploring the relationships between work-related exposures and health outcomes uses two methods to assess worker health outcomes: self reported measures of health (e.g., constructs such as low back pain disability and chronic conditions) and employee record data (e.g., workers compensation claims, injury reports). In this competitive revision, we propose to add objective measures of health that are clinical markers for disease risk. The addition of objective health measures substantially strengthens the overall conceptual framework developed using subjective measures and administrative workplace data. The current study proposes to evaluate the relationships among the mediating mechanisms (e.g., physical and psychosocial exposures on the job, social norms and social support), modifying conditions (e.g., socioeconomic position, race/ethnicity, gender, managerial attitudes), proximal outcomes (e.g., fatigue, job satisfaction), and self-reported worker health outcomes (e.g., low back pain disability, health behaviors) through a survey of a random sub-sample (n=1200) of patient care workers. Furthermore, the relationships of organizational policies and programs and selected worker health outcomes will be investigated. We now propose to evaluate objective worker health outcomes, including blood-based biomarkers (CHD risk, and including diabetes risk, chronic inflammation, and stress-mediated immunosuppression), vital signs, height/weight/girth in a subset of the surveyed workers. The proposed competing revision adds important objective measures of worker health outcomes, which are not a part of the current study. The collection of these objective measures would additionally allow us to compare findings with related NIOSH/NIH-funded research through the Work, Family, and Health Network.