Certified Nursing Assistants’ Barriers and Facilitators to Accessing and Using Worksite Health Promotion Programs

Abstract

Objective: Certified nursing assistants (CNAs) are low-wage healthcare workers who provide direct care to nursing home residents, yet also experience significant health disparities. However, limited research has been conducted on CNAs’ perceived barriers and facilitators to workplace health promotion (WHP) participation. Method: Informed by the Consolidated Framework for Implementation Research (CFIR), 24 CNA semi-structured, in-depth interviews were conducted in two Chicagoland nursing homes. Results: Key barriers were time-constraints and lack of staffing, lack of access to WHP programs, and limited organizational and employer support. Facilitators included the availability of WHP programs, breaks, and other workplace benefits, and enhanced leadership and familial support. Conclusion: An effective WHP program must attempt to minimize the work-related, organizational, and environmental barriers while supporting high motivation of CNAs in health promotion. We offer some suggestions for enhancing CNAs’ WHP access and utilization.

A qualitative study exploring the implementation determinants of rehabilitation and global wellness programs for orchestral musicians

“…Despite the uniqueness of musicians’ work demands and culture, among other factors, 3 certain parallels can be drawn between professional musicians and populations such as healthcare professionals, athletes and firefighters (to name a few), lending to the generalisability of this study’s findings. 30,31 This becomes apparent when considering the implementation determinants of workplace wellness programs catered to the aforementioned populations and office workers, 32,33 which are similar to the determinants in musicians. Indeed, in a scoping review of the implementation determinants of physical activity interventions in a variety of working populations (healthcare and office workers, firefighters) the identified determinants were Environmental Context and Resources (including culture, lack of time, scheduling conflicts, flexibility and simplicity of programs), Social Influences (social/collegial support), and Social/Professional Role and Identity (including behaviours, group identity, organisational commitment), 33 which are all among the main determinants identified in our study.…”

“…Potential compatibility issues, a determinant shared with most occupational populations, 32,33 pertain to finding appropriate moments and sufficient time for program activities considering orchestra schedules. Importantly, a considerable strain to musicians’ well-being is their lack of control over their work schedules and job requirements.…”

“…Importantly, a considerable strain to musicians’ well-being is their lack of control over their work schedules and job requirements. 3 In addition to the obstacle of not being able to take breaks, like nurses, 32 this low external locus of control greatly increases musicians’ risk of overuse, as the need to follow conductors and orchestra schedules overrides the possibility of resting when they are exhausted and performing like athletes. 3,31 We perceive an association between the importance of compatibility in our discussions and the intrinsic obstacles to self-care in musicians’ workplace.…”

Unique Barriers to Workplace Health Promotion Programs by Wage Category: A Qualitative Assessment of Secondary Data

“…7 Several factors may influence participation in WHP programs, including work-related factors (e.g., job roles and responsibilities, staffing levels, and organizational support), environmental barriers or facilitators (e.g., social determinants of health (SDoH) as described below), or personal preferences for certain WHP programs. 13 For example, hourly workers may have difficulty participating in WHP programs because they lack the flexibility to leave their posts during scheduled work time. Part-time or temporary workers may also be excluded from participation due to their employment status, and shift-workers may have difficulty participating in programs that are offered during the normal workday.…”

Diversity equity and Inclusion: To advance infection prevention and control efforts, nursing assistants need to be given the opportunity to dance

“…Of the nearly 600,000 nursing assistants employed in nursing homes and 380,000 in hospital settings, 50% are from a racial or ethnic minority background, 14% are of immigrant status, and 17% are considered low income. 4 , 5 , 6 , 7 Despite having important responsibilities in the health care setting with an influence on IPC, such as assisting with bathing, feeding, and toileting, being the eyes and ears of the nurse, and knowing the resident and/or patient best, this workforce is often disrespected, undervalued, underutilized, and excluded from important conversations in the nursing home and hospital setting. 6 These experiences among nursing assistants and the subsequent poor outcomes for both residents and/or patients (eg, infections) and nursing assistants (eg, burnout, turnover) can be largely attributed to health care organizations failing to uphold important DEI principles meant to enhance the care and work environment for residents and/or patients and staff who come from diverse and underrepresented backgrounds.…”