Work organization is an important determinant of employee psychological and physical well being. Depression and musculoskeletal disorders are outcomes of adverse work organization that inflict major social and economic burden on workers, firms and communities, including chronic disability and suicide. Home care work has been found to be one of the most physically, and possibly psychologically, hazardous work environments in the U.S., a disturbing finding as home care is contently the fastest growing occupation in the Country. The proposed study will assess the relationship between the organization of work and the prevalence of major depression and musculoskeletal disorders among home care workers. A cross-sectional study will be conducted of 1520 home care workers drawn from a large and diverse population in Los Angeles County, California. The overarching hypothesis of this three year study is that work organization (i.e., the amount of work to be performed and the capacity to decide how to do it) will have a direct association with the prevalence of major depression and musculoskeletal disorders among home care workers. This will be the first study in the U.S. to examine work organization factors in the home care industry in relation to the prevalence of depression and musculoskeletal disorders among home care workers. This study will also make important methodological contributions to the field of occupational health. Home care workers are a """"""""hard-to-reach,"""""""" special population at risk (with a high proportion of poor, minorities, immigrants and women) and as such we will use computer-assisted telephone interviewing to minimize respondent effort in participating. In addition, work organization will be measured among home care workers under standard and non-standard (part-time, on-call) work arrangements. We will employ a newly developed screening instrument for depression with improved content validity and domain representativeness compared to other non-clinical instruments for this outcome. The results of this study will have implications for work place policies in home care agencies across the U.S. that have the potential to reduce depression and musculoskeletal disorders, as well as the associated loss of productivity from these disorders among home care workers.
| Delp, Linda; Wallace, Steven P; Geiger-Brown, Jeanne et al. (2010) Job stress and job satisfaction: home care workers in a consumer-directed model of care. Health Serv Res 45:922-40 |
