Work Design, Self-Management, and Work Ability in Workers with Diabetes

项目总结 糖尿病是美国成年人中常见的慢性病，估计有3410万成年人受到影响；它还 不成比例地影响到社会经济地位较低的人。糖尿病的管理是复杂的，涉及 生活方式改变(即，体力活动和饮食改变)、体重管理、血糖水平监测、 使用口服药物或胰岛素，并定期就医。不幸的是，糟糕的治疗依从性 增加糖尿病相关并发症(如慢性肾脏疾病、视力丧失、心脏病、 和神经损伤)和死亡率。工作场所是一个可以影响疾病管理的关键环境， 而工作会干扰患有慢性病的工人的健康管理。蓝领和服务业 行业员工可能面临更大的风险，因为与白领相比，他们在工作中相对缺乏灵活性 工人们。我们的长期目标是开发和评估干预措施，以解决导致 导致蓝领和糖尿病服务人员工作能力低，自我管理能力差 目前缺乏干预措施。在目前的R03研究中，我们评估了与工作相关的糖尿病预测因素 美国蓝领和服务业糖尿病患者的自我管理和工作能力；结果将 通知未来的干预措施。这项R03研究是一项混合方法的研究，在这项研究中，我们将首先采访25名蓝色- 领班和2型糖尿病服务人员了解他们在工作中需要保持的东西 他们的工作能力，在工作的同时管理他们的糖尿病。这些定性数据将使我们能够检查一些 我们从理论上提出的主张，修改模型，和/或添加我们最初没有提出的变量。然后，我们 我将使用270名糖尿病患者的两次定量调查数据来验证所得到的模型 最后，与5名糖尿病工人进行访谈，以检查调查研究结果。该模型将 包括与工作相关预测因素(组织支持、主管支持、健康支持主管 行为、工作控制、各种形式的灵活性)、个体预测因素(习惯强度、糖尿病管理 自我效能感和疾病负担)、工作能力和糖尿病自我管理(无意用药 不遵守、血糖监测、体力活动、饮食管理和医疗预约) 结果。结果将包括确定自我管理和工作能力的最重要预测因素 通过相对重要性分析。这项工作支持NIOSH的全员健康®(TWh)使命， NIOSH的战略目标7和健康工作设计和福祉跨部门计划的战略目标 促进安全和健康的工作设计和弱势工人的福祉。科学成果将包括 介绍研究结果的演示文稿和同行评审的期刊文章。从研究到实践 (R2P)，这些数据将在开发和评估组织之前提供必要的信息 对糖尿病工人的干预，我们计划在未来的R01提案中这样做。通过这些 这项研究将解决美国劳动力中一个关键的未得到满足的需求。

PROJECT SUMMARY Diabetes is a common chronic condition among U.S. adults, affecting an estimated 34.1 million adults; it also disproportionately affects those of lower socio-economic status. Diabetes management is complex, involving lifestyle changes (i.e., physical activity and dietary changes), weight management, glucose level monitoring, the use of oral medications or insulin, and regular medical care visits. Unfortunately, poor treatment adherence increases the risk for diabetes related complications (e.g., chronic kidney disease, vision loss, heart disease, and nerve damage) and mortality. The workplace is a critical context that can influence disease management, and work can interfere with health management in workers with chronic conditions. Blue-collar and service sector workers are likely at greater risk, given their relative lack of flexibility at work compared to white-collar workers. Our long-term goal is to develop and assess an intervention to address work-related factors that lead to low work ability, and poor self-management in blue-collar and service workers with diabetes, as such interventions are currently lacking. In this current R03 study, we assess work-related predictors of diabetes self-management and work ability in U.S. blue-collar and service sector workers with diabetes; results will inform future interventions. This R03 study is a mixed methods study, in which we will first interview 25 blue- collar and service workers with type 2 diabetes to get their perceptions of what they need at work to maintain their work ability and manage their diabetes alongside work. This qualitative data will allow us to check some of our propositions from theory, revise the model, and/or add variables that we did not initially propose. Then, we will validate the resulting model using quantitative survey data from 270 workers with diabetes at two time points, and finish with interviews with 5 workers with diabetes to check survey study results. The model will include work-related predictors (organizational support, supervisor support, health-supportive supervisor behaviors, job control, various forms of flexibility), individual predictors (habit strength, diabetes management self-efficacy, and disease burden), and work ability and diabetes self-management (unintentional medication non-adherence, glucose monitoring, physical activity, dietary management, and medical appointments) as outcomes. Results will include identifying the most important predictors of self-management and work ability through relative importance analysis. This work supports NIOSH’s Total Worker Health® (TWH) mission, NIOSH’s strategic goal 7 and strategic goals of the Healthy Work Design and Well-Being cross-sector program to promote safe and healthy work design and well-being in vulnerable workers. Scientific outputs will include presentations and peer-reviewed journal articles that present study results. In terms of Research to Practice (R2P), these data will provide necessary information prior to developing and evaluating an organizational intervention to support workers with diabetes, which we plan to do in a future R01 proposal. Through these outputs, this study will address a critical unmet need in the U.S. workforce.