Soo-Jeong Lee

Background: Workplace violence towards healthcare workers impacts workforce stability and patient care delivery. California passed a workplace violence prevention standard, phased in during 2017‐2018, requiring enhanced tracking and training in healthcare workplaces. Workers' compensation claims provide a tool to track frequency of violence over time. Methods: This descriptive study synthesizes data from the California Workers' Compensation Information System (WCIS) covering all healthcare workplaces in the state. Claims included were filed from 2013 to 2021. We tabulated the annual rate of workplace violence‐related claims, types of workplaces with high rates of claims, and types of injuries caused by violence. Results: We identified 46,762 violence‐related workers' compensation claims over the study period from a total of 418,278 total claims (11%). The highest rate of violence‐related claims was in 2019 (5.6 claims per 1000 healthcare workers). Residential care facilities for children reported 31% of their total claims as violence‐related, and psychiatric and substance‐use hospitals reported 35% of their total claims as violence‐related. Most healthcare industry claims were from individuals working in hospitals, and employees in these workplaces reported between 11% and 13% of total claims as violence‐related. Conclusions: Workers' compensation claims provide an important description of workplace violence exposure among healthcare workers, and the relative stability of measurement makes it a useful way to track the impact of mitigation strategies over time. It would be valuable for workers' compensation claims managers to capture an assessment of whether an incident involved violence to facilitate appropriate connection to needed resources, including psychological support, for an injured worker.

Objective: To examine the association between frequency of mobile clinic visits and diabetes or hypertension control among patients who received regular mobile clinic care, controlling for patient sociodemographic characteristics and comorbidities. Design: Retrospective cohort study using patient chart review. Sample: Patients who regularly visited mobile medical clinics in Southern California (N = 218) between 1 January 2018 and 31 December 2019. Measurements: The dependent variables were hemoglobin A1c and blood pressure control. The independent variable was number of visits per year. Longitudinal associations were examined using a linear mixed model or generalized linear mixed model. Results: Among regular mobile clinic patients with diabetes (n = 86), there was no significant association between number of visits and hemoglobin A1c control (hemoglobin A1c < 6.5). Among regular mobile clinic patients with hypertension (n = 129), the odds of hypertension control (blood pressure < 140/90 mmHg) over time significantly increased as the frequency of clinic visits increased (adjusted OR = 5.27, 95% CI 1.63–16.99). Conclusions: The study findings suggest that regular mobile clinic use by adults with hypertension improves blood pressure control over time. However, the frequency of mobile clinic visits had no effect on diabetes control overtime. Patients with diabetes need additional interventions to achieve hemoglobin A1c control.

The growing aging population and rising prevalence of dementia are driving increased demand for long‐term care services and supports in the United States. People with dementia require substantial support and care, often from direct care workers in private homes, assisted living communities, and nursing homes. Despite their crucial role, these workers receive highly variable training, particularly in dementia care, and face significant work‐related challenges including stress, injury, and burnout. The National Dementia Workforce Study (NDWS), sponsored by the National Institute on Aging, was designed to include large‐scale, nationally representative annual surveys of staff and administrators providing care to individuals with dementia in home care, assisted living, and nursing homes, and of community clinicians practicing across settings. NDWS will capture workforce demographics, training adequacy, job satisfaction, and their impact on dementia care quality. This report describes NDWS's rigorous process for questionnaire design for the initial wave of home care, assisted living, and nursing home surveys. Our survey development methods integrated literature reviews, validated questionnaire items, expert consultations, and cognitive interviews to ensure instrument reliability and validity. Resulting survey data will be available to researchers seeking to examine workforce conditions, training, and worker knowledge, and their impact on care for people with dementia. NDWS infrastructure will also allow researchers to link survey responses with administrative and medical claims data to examine how workforce dynamics and organizational factors are associated with outcomes for people with dementia over time, enabling insights into policies to improve dementia care training, workforce retention, and care delivery.

Background: Workers’ reporting of work-related injuries or illnesses is important for treatment and prevention, yet research often focuses on reporting barriers. This study aimed to identify factors related to work-related musculoskeletal disorder (WRMSD) reporting attitudes and their connection to reporting intention and behavior. Methods: We analyzed data from 377 direct care workers employed in 19 long-term care facilities in South Korea. A self-administered questionnaire collected demographics, job characteristics, physical and psychosocial factors, musculoskeletal symptoms, reporting attitudes, and WRMSD reporting intentions and behavior between May and August 2022. We used a generalized linear mixed model with a random intercept by employers to identify factors influencing reporting attitudes. To explore the relationship between reporting attitude and reporting intention and behavior, simple logistic regression was also conducted. Results: We achieved an 86% response rate. The majority of the study participants were female (87.2%), married (95.9%), and non-immigrant (72.8%). Of the study participants, 48.9% had no intention to report WRMSDs, and 44.3% held negative reporting attitudes. Among 200 workers with WRMSDs, 86.5% did not report them. Attitudes were associated with work duration, safety training, management safety priority, WRMSD experience, and symptom severity and frequency. Management safety priority did not moderate this relationship. Significant links existed between attitudes and reporting intention and behavior. Conclusions/Applications to Practice: This study highlights the vital influence of workers' attitudes on reporting work-related injuries and illnesses. Occupational health providers should employ strategies, such as tailored safety training and management commitment, with a focus on addressing the unique needs of long-tenured and musculoskeletal-exposed workers. Fostering a safety culture that promotes open and timely reporting is crucial, and implementing these strategies can significantly enhance workplace safety and health.

Background: The coronavirus disease 2019 (COVID‐19) pandemic greatly affected healthcare workers, both physically and psychologically, by increasing their workload and stress. This may also have increased their risk of occupational injuries. This study analyzed workers' compensation (WC) claims among California nursing care facility workers during 2019–2021, to assess the impact of the pandemic on occupational injury risk.Methods: This study used data from the California Workers' Compensation Information System. WC claims in prepandemic and pandemic periods were described and compared between nursing care facilities and other settings. Nursing facility cases were described by demographic, job, and injury characteristics.Results: In 2019–2021, we identified 41,134 claims as nursing facility cases in California. Annual claims increased by 64.6% from 2019 to 2020 and then decreased in 2021, returning to levels similar to pre‐COVID. In contrast, non‐healthcare settings had decreases in claims during the pandemic. COVID‐related claims accounted for 50.5% of claims in nursing facilities in 2020–2021; this proportion was much higher compared with other healthcare (35.7%) or nonhealthcare settings (14.3%). Non‐COVID claims decreased during the pandemic but mental disorder or stress claims increased in nursing facilities, particularly in 2020 (+42.5%).Conclusions: Our findings show that nursing care facilities were more severely affected by the pandemic than other settings. We did not find evidence of an increased risk of occupational injuries during the pandemic, except for increased claims for stress or mental disorders. Our findings indicate a clear need to address psychological stress and mental health among nursing facility workers during a pandemic.

This study explored racial and ethnic differences in perception of work environment, safe work practices, general health status, experience of work-related injury or illness and subsequent symptom reporting and health care seeking behaviors among cleaning workers. This study analyzed cross-sectional data obtained from 183 cleaning workers employed in a university hospital or a health sciences campus in Northern California. The sample included 120 Asians (65.6%), 37 Hispanics (20.2%), and 27 other ethnicities (14.2%); 85.7% were foreign-born. Asian workers perceived lower job control and supervisor support and higher job strain than other workers. The odds of perceiving general health as excellent or very good were lower among Asians compared to Hispanics and Others. Asians who experienced chemical-related symptoms were less likely than Hispanics and others to report the symptoms to their supervisor or seek healthcare. Our study findings indicated racial/ethnic differences in perceptions of work and general health, seeking healthcare, and reporting behaviors among cleaning workers. Asian workers, specifically, may need special attention to improve their experiences of work environments and health in the workplace.

Many American workers spend over 7 hours a day at work in primarily sedentary office work. Physical activity is a key aspect of optimizing health and preventing disease; yet, 80% of American adults do not meet the recommended guidelines for physical activity. In this systematic review, the relationship between physical work environment and physical activity among office workers was explored. Of the 321 studies screened, 26 studies met the eligibility criteria and were included for evaluation in this systematic review. Of the 26 studies, four were cross-sectional studies, 14 were quasi-experimental studies, and eight were randomized control trials. Physical activity during the workday was measured using self-report surveys and electromechanical devices such as accelerometers. Physical work environments examined by the studies included different types of desks (n = 16), office arrangements (n = 5), and building design (n = 5). In nine studies, office environments and building work environments designed to promote activity using active design principles such as stairs and flexible workspaces were associated with increased physical activity. Sit–stand desks reduced overall sitting time, but had a minimal effect on physical activity. Offices and buildings designed for activity had the largest impact on physical activity among office workers. To increase physical activity in office workers, focus should be placed on opportunities to increase incidental movement that can increase physical activity throughout the workday. Occupational health nurses should advocate workspace designs that can increase physical activity in workers.