Supervisor and organizational factors associated with supervisors' support for work accommodation in low back pain injured workers

Transcription

1 Supervisor and organizational factors associated with supervisors' support for work accommodation in low back pain injured workers Vicki L Kristman Ph.D. May 27, 2014 Institute for Work & Health Plenary

2 Research Team Vicki Kristman Bill Shaw Kelly Williams-Whitt Sophie Soklaridis Patrick Loisel 2

3 Musculoskeletal Disorders Major cause of human suffering, workplace disability, lost productivity, and economic loss Ontario - musculoskeletal conditions cause 40% of all chronic conditions 54% of all long-term disability 24% of all restricted activity days Low back pain (LBP) - most common MSD affecting working age adults LBP-related costs exceed $50 billion annually in USA Majority of cost attributable to prolonged disability

4 Workplace Accommodation Temporary work accommodation facilitates early return to work Supervisors: gatekeepers and facilitators of job accommodations Process of developing and supporting job accommodations is poorly understood

5 Objective To determine the association between organizational/job factors and supervisor characteristics and supervisors decisions to support workplace accommodation for injured workers with LBP

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7 Study Design Cross-sectional study of supervisors Partnered with Canadian and US employers Supervisors invited to participate through employer Supervisor eligibility criteria: 18+ years old English-speaking supervised 1 worker Data collection: Web-based, self-report survey Dec Jan. 2013

8 Survey Design Supervisors instructed to: identify job position typical of supervised workers rate physical job demands of typical job position respond to survey instruments and questions with respect to typical job position

9 Case vignette methodology Case vignette = Scenario of a LBP-injured worker returning to work Case vignette approach allowed us to: standardize the decision-making scenario contextualize the experience test hypothesized variables Randomized conditions within vignette (worker s gender; location of injury; prior work absences) Random assignment to 1 of 8 case vignettes

10 Job Accommodation Scale (JAS) Measured study outcome likeliness of supporting job accommodations based on case vignette Novel instrument 21 items representing specific job accommodations 4 point Likert-type scale: 1 ( very unlikely ) to 4 ( very likely ) Cronbach s α =.85

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14 Factors Autonomy Modelled on Job Content Questionnaire; Karasek et al., 1998 Organizational Disability Management Policies & Practices Occupational Policies and Practices (OPP) scale; Amick et al., 2000 Corporate Safety Culture Global Work Safety Climate (GWSC) scale; Hahn & Murphy, 2008 Workplace Social Capital Social Capital at Work Questionnaire (SCWQ); Kouvonen et al., 2008; Oksanen 2008 Pain and Work Disability Beliefs Pain and Impairment Relationship Scale (PAIRS); Riley et al., 1988; Slater et al., 1991 Leadership Style Consideration & Initiating Structure Leader Description Behaviour Questionnaire (LBDQ); Halpin 1957 * Factors based on supervisors perceptions.

15 Covariates Physical job demands Heavy Physical Workload and Long-lasting Postures & Repetitive Movements Physical Workload Questionnaire (PWQ); Bot et al., 2004 Demographic variables Supervisor age, gender, country of residence & education Work experience (managerial level, years with company & years as supervisor) Number of supervised workers Worker unionization

16 Statistical Analysis Univariate and bivariate analyses Multivariable generalized linear regression with clustering by employer 1) Bivariate analyses with outcome and each predictor/covariate 2) Variables with p value.2 entered into initial multivariable model (full model) 3) Derived reduced models from initial model 4) Selection of final reduced model based on inclusion of important variables; predictive ability (R 2 ); parsimony

17 Results: Supervisor Participation Overall supervisor participation rate: 26.1% 804 supervisors from 19 employers (10 US and 9 Canadian) participated 796 eligible supervisors

18 Supervisors according to industry sector 25% 4% 2% Utilities Manufacturing 11% 2% 56% Construction Retail & Wholesale Trade Health Care & Social Assistance Education Services

19 Supervisor Characteristics N Mean (SD) Range Age (9.6) Years as supervisor (9.7).8-39 Years with company (9.8).8-45 N Number of supervisors (%) US residents (60.2) Male (73.0) Frontline supervisors (69.9) Completed post-secondary (57.7) Note: Results based on responding supervisors; they do not account for missing responses.

20 Supervisor Characteristics Number of supervisors (%) 20+ supervised workers (45.6) Only non-unionized workers (54.9) N Mean Score (SD) Range of Possible scores Heavy Physical Work (20.7) 0 100% Long-Lasting Postures & Repetitive Movements (22.4) 0 100% Note: Results based on responding supervisors; they do not account for missing responses.

21 Outcome Range of Possible N Mean (SD) Scores JAS score (0.5) 1-4 Overall high level of support for job accommodations Very similar JAS scores for all case vignettes Case vignettes treated as single group for regression analysis

22 Distribution of JAS responses by accommodation type % of supervisor responses Very or Somewhat unlikely Very or somewhat likely Response options Not an option Modify physical workload Modify work environment Modify work schedule Find alternate duties Arrange for assistance

23 Factors Range of N Mean score (SD) Possible Scores Autonomy (1.1) 1-5 Disability Management (0.6) 1-5 Corporate Safety Culture (0.4) 1-4 Workplace Social Capital (0.7) 1-5 Leadership Style - Consideration (8.4) 0 100% Leadership Style Initiating Structure (9.5) 0 100% Pain & Work Disability Beliefs (8.1) %

24 Initial Multivariable Model Autonomy Corporate Safety Culture Disability Management Workplace Social Capital Leadership Style - Consideration Leadership Style - Initiating Structure Country of residence (Canada) Gender (Female) Heavy Physical Work Long-lasting Postures & Repetitive Movements Managerial Level Prior Worker Absences (case vignette) 12 variables in the initial model explained 18.7% of variance in supervisors likeliness to support job accommodations N = 582; Adjusted R 2 =.187; 95% CI [.132;.243]

25 Final Model Coef. (95% CI) 5 variables in the final reduced model explained 17.7% of variance in supervisors likeliness to support job accommodations. Autonomy.066 (.026;.107) Disability Management.188 (.130;.246) Leadership Style - Consideration.014 (.011;.016) Workplace Social Capital (-.146; -.021) Canada.103 (.046;.160) Disability Management & Consideration explained 13.6% of variance in supervisors likeliness to support job accommodations. N = 582; Adjusted R 2 =.177; 95% CI [.121;.233]

26 Discussion First study to examine these multiple explanatory factors in this context Better understanding of variables that have an influence on supervisors support for job accommodations Organizational factors more important than demographic and other job factors Most important variables are potentially modifiable targets of interventions

27 Discussion Strengths Large number of supervisors Range of industry sectors Breadth of domains surveyed with validated measures Limitations Low supervisor participation rate Cross-sectional study design Case vignette approach hypothetical

28 Conclusions & Future Directions Supervisors support for job accommodations is influenced by several potentially modifiable variables Develop and support DM policies and practices Application of findings to supervisor training programs Develop JAS for other chronic conditions including cancer Further research needed to confirm the study results identify other factors that influence supervisors decisions about job accommodations

29 Acknowledgements This research was supported by the CIHR and the Liberty Mutual Research Institute for Safety Sincere thanks to Sara Macdonald of the Institute for Work & Health KTE department for assistance with recruiting Canadian employers

30 Thank You!

31 Contact information: Vicki Kristman:

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