To describe the value of participatory methods for achieving successful workplace health promotion (WHP) programming, and specifically the relevance of participatory ergonomics (PE) for the Total Worker Health (TWH) initiative. We review the concept of macroergonomics, and how PE is embedded within that framework, and its utility to modern WHP approaches such as "social health promotion." We illustrate these constructs in practice within TWH. Participatory ergonomics is relevant to WHP because (1) psychosocial stress contributes to individual health behaviors as well as chronic diseases; (2) job stress cannot be addressed without employee involvement in hazard identification and solutions; (3) the interaction of multiple levels within an organization requires attention to needs and constraints at all levels, just as the social-ecological model addresses higher-level determinants of and constraints on individual behaviors.

Objective: As part of a Research-to-Practice Toolkit development effort by the Center for the Promotion of Health in the New England Workplace, to develop and test a structured participatory approach for engaging front-line employees in the design of integrated health protection and promotion interventions. Methods: On the basis of a participatory ergonomics framework, the Intervention Design and Analysis Scorecard (IDEAS) provides a stepwise approach for developing intervention proposals, including root cause analysis and setting evaluation criteria such as scope, obstacles, and cost/benefit trade-offs. The IDEAS was tested at four diverse worksites with trained facilitators. Results: Employees were able to develop and gain management support for integrated interventions at each worksite. Conclusions: The IDEAS can be used effectively by front-line employees to plan integrated interventions in a program dedicated to continuous improvement of employee health protection/promotion and Total Worker Health.

The rising U.S. prevalence of obesity has generated significant concern and demonstrates striking socioeconomic and racial/ethnic disparities. Most interventions target individual behaviors, sometimes in combination with improving the physical environment in the community but rarely involving modifications of the work environment. With 3.6 million workers earning at or below the federal minimum wage, it is imperative to understand the impact of working conditions on health and weight for lower income workers. To investigate this question, a university–community partnership created a participatory research team and conducted eight focus groups, in English and Spanish, with people holding low-wage jobs in various industries. Analysis of transcripts identified four themes: physically demanding work (illnesses, injuries, leisure-time physical activity), psychosocial work stressors (high demands, low control, low social support, poor treatment), food environment at work (available food choices, kitchen equipment), and time pressure (scheduling, having multiple jobs and responsibilities). Physical and psychosocial features of work were identified as important antecedents for overweight. In particular, nontraditional work shifts and inflexible schedules limited participants’ ability to adhere to public health recommendations for diet and physical activity. Workplace programs to address obesity in low-wage workers must include the effect of working conditions as a fundamental starting point.

Focus groups are often used for qualitative investigations. We adapted a published focus group method for evaluating impact of an organizational intervention for virtual delivery using video conferencing. The method entailed convening small groups of three to five participants for a 2-hour facilitated workshop. We delivered the virtual workshops, adding qualitative evaluation with researchers and participants, to assess the effectiveness of the protocol. We address the questions of how to structure the data collection procedures; whether virtual delivery permits cross participant interactions about a studied intervention; and how easy and comfortable the experience was for participants. Participants were university faculty members who were the focus of an institutional diversity program. The results indicated that the virtually delivered focus group workshop could be successfully implemented with strong fidelity to the original protocol to achieve the workshop goals. The workshops generated rich data about the impacts of the institutional program as well as other events and conditions in the working environment that were relevant to consider along with the observed program outcomes. A well-planned virtual focus group protocol is a valuable tool to engage intervention stakeholders for research and evaluation from a distance. Video conferencing is especially useful during the current COVID-19 pandemic, but also whenever geography separates researchers and evaluators from program stakeholders. Careful planning of privacy measures for a secure online environment and procedures for structured facilitation of group dialogue are critical for success, as in any focus group. This article addresses a gap in the literature on feasibility and methodology for using video conference technology to conduct qualitative data collection with groups.

Depression is the second leading cause of disability worldwide. Health care workers report a higher prevalence of depressive symptoms than the general population. Emotional labor has contributed to poor health and work outcomes. However, the mechanism for the potential association between emotional labor and depressive symptoms has not been well studied. This study examines the relationship between emotional labor and depressive symptoms and whether sleep plays a role in explaining this relationship. In 2018, health care workers (n = 1,060) from five public sector facilities in the northeast United States participated in this cross-sectional survey. The survey included questions on participants’ surface-acting emotional labor (masking one’s feelings at work), depressive symptoms, sleep duration and disturbances, and socio-demographic characteristics. Multivariable linear and Poisson regression modeling were used to examine associations among variables. There was a significant association between emotional labor and depressive symptoms (β = 0.82, p < .001). Sleep disturbances, but not short sleep duration, partially mediated this association. Neither sleep variable moderated this association. Depressive symptoms were prevalent among health care workers and were associated with emotional masking. Sleep disturbances play an important intermediate role in translating emotional labor to depressive symptoms in these workers. Effective workplace programs are needed to reduce health care workers’ emotional labor to improve their mental health. Sleep promotion should also be emphasized to mitigate the negative effect of emotional labor and promote mental wellbeing.