Using Total Worker Health® Implementation Guidelines to Design an Organizational Intervention for Low-Wage Food Service Workers: The Workplace Organizational Health Study

Total Worker Health® (TWH) interventions that utilize integrated approaches to advance worker safety, health, and well-being can be challenging to design and implement in practice. This may be especially true for the food service industry, characterized by high levels of injury and turnover. This paper illustrates how we used TWH Implementation Guidelines to develop and implement an organizational intervention to improve pain, injury, and well-being among low-wage food service workers. We used the Guidelines to develop the intervention in two main ways: first, we used the six key characteristics of an integrated approach (leadership commitment; participation; positive working conditions; collaborative strategies; adherence; data-driven change) to create the foundation of the intervention; second, we used the four stages to guide integrated intervention planning. For each stage (engaging collaborators; planning; implementing; evaluating for improvement), the Guidelines provided a flexible and iterative process to plan the intervention to improve safety and ergonomics, work intensity, and job enrichment. This paper provides a real-world example of how the Guidelines can be used to develop a complex TWH intervention for food service workers that is responsive to organizational context and addresses targeted working conditions. Application of the Guidelines is likely transferable to other industries.

Outbreak of P.3 (Theta) SARS-CoV-2 emerging variant of concern among food service workers in Louisiana

In May, 2021, during routine oil and gas industrial quarantine/premobilization procedures, four individuals who recently arrived to Louisiana from the Philippines tested positive for SARS-CoV-2. Subsequent genomic analysis showed that all were infected with a Variant of Interest (P.3-Theta). This increases the number of known P.3 infections in the United States to eleven and highlights the importance of genomic surveillance within industries that are prone to rapidly spread the infection.

Food Waste in Schools: A Pre-/Post-Test Study Design Examining the Impact of a Food Service Training Intervention to Reduce Food Waste

This study aimed to assess change in school-based food waste after training and implementing the Smarter Lunchrooms Movement (SLM) strategies with school food service workers. This non-controlled trial was implemented in a random sample of 15 elementary and middle schools in a Community Eligibility Program school district in the Northeast, the United States. Baseline and post-intervention food waste measurements were collected at two different time points in each school (n = 9258 total trays measured). Descriptive statistics, independent t-tests, and regression analyses were used to assess SLM strategies’ impact on changes in percent food waste. The mean number of strategies schools implemented consistently was 7.40 ± 6.97 SD, with a range of 0 to 28 consistent strategies. Independent t-tests revealed that at post-test, there was a significant (p < 0.001) percent reduction (7.0%) in total student food waste and for each food component: fruit (13.6%), vegetable (7.1%), and milk (4.3%). Overall, a training session on food waste and the SLM strategies with school-based food service workers reduced school food waste. However, the extent of the training and SLM strategies to reduce food waste varied on the basis of the consistency and type of strategies implemented.

Psychological and Physical Risk Factors for Pressure Pain Hypersensitivity of the Upper Trapezius in Food Service Workers With Nonspecific Neck/shoulder Myofascial Pain

Objectives: It is unclear which factors increase the risk of developing pressure pain hypersensitivity, a type of neurophysiological hyperexcitability. The present study investigated the relative contributions of physical and psychological factors to pressure pain hypersensitivity of the upper trapezius for each sex.Methods: In total, 154 individuals with neck/shoulder myofascial pain participated, among 372 food service workers. Participants completed a questionnaire (age, sex, Beck Depression Inventory, and Borg Rating of Perceived Exertion scale) and then were photographed to measure posture. Pressure pain sensitivity, two range of motions (cervical lateral-bending and rotation), and four muscle strengths (serratus anterior, lower trapezius, biceps, and glenohumeral external rotator) were measured by a pressure algometer, iPhone application, and handheld dynamometer. For each sex, forward multivariate logistic regression was used to test our a priori hypothesis among selected variables that a combination of psychosocial and physical factors contributed to the risk for pressure pain hypersensitivity.Results: In multivariate analyses, lower trapezius strength (odds ratio = 0.94, 95% confidence interval = 0.91–0.97, p = 0.001) was the only significant risk factor for pressure pain hypersensitivity in men. Dominant painful ipsilateral cervical rotation range of motion (odds ratio = 0.96, 95% confidence interval = 0.92–0.99, p = 0.037) was the only risk factor for pressure pain hypersensitivity in women.Discussion: Lower trapezius strength and dominant painful ipsilateral cervical rotation range of motion could serve as guidelines for preventing and managing pressure pain hypersensitivity of the upper trapezius in food service workers with nonspecific neck/shoulder myofascial pain.Trial registration: Research Information Service (CRIS) under the code KCT0002810 (granted on 20/04/2018) and the registration timing was retrospective.

Staff Perceptions of a Mealtime Management Educational Video for Training in Long-Term Care Homes

The purpose of this study was to determine if staff perceive a mealtime management video to be a beneficial and useful training tool in long-term care (LTC) homes. An email invitation was sent to the Dietitians of Canada Gerontology Network inviting dietitians working in LTC homes to participate. A previously used and reliable 25-item questionnaire was used to assess sustained attention/mental effort, learner satisfaction, clinical experience/relevance, and information processing of the video. Dietitians were asked to show the video to LTC staff and distribute the questionnaire to staff after viewing the video. A total of 769 surveys were completed at 28 LTC homes across Canada. Eighty-seven percent (n = 637/736) of participants felt more knowledgeable after viewing the video and 91% (n = 669/738) found the video format easy for learning. Managers had a higher Likert scores (mean = 6.2 out of 7) than continuing care assistant (mean = 5.7, P = 0.02) and food service workers (mean = 5.5, P = 0.001) for the clinical relevance scales. No differences were found for age (χ2 = 5.52, P = 0.60), gender (χ2 = 2.65, P = 0.10), and size of home (χ2 = 3.34, P = 0.34). Staff perceived the video to be useful for their work with residents living in LTC homes and it raised awareness of the importance of their roles at mealtimes.

Prevalence of Occupation Associated with Increased Mobility During COVID-19 Pandemic

PurposeIdentifying geographic-level prevalence of occupations associated with mobility during local stay-at-home pandemic mandate.MethodsA spatio-temporal ecological framework was applied to determine census-tracts that had significantly higher rates of occupations likely to be deemed essential: food-service, business and finance, healthcare support, and maintenance. Real-time mobility data was used to determine the average daily percent of residents not leaving their place of residence. Spatial regression models were constructed for each occupation proportion among census-tracts within a large urban area.ResultsAfter adjusting for demographics, results indicate census-tracts with higher proportion of food-service workers, healthcare support employees, and office administration staff are likely to have increased mobility.ConclusionsIncreased mobility among communities is likely to exacerbate COVID-19 mitigation efforts. This increase in mobility was also found associated with specific demographics suggesting it may be occurring among underserved and vulnerable populations. We find that prevalence of essential employment presents itself as a candidate for driving inequity in morbidity and mortality of COVID-19.

Asymmetric Load Carriage at Shoulder Height affects Temporal Gait Characteristics among Food Service Workers

Slips and falls are common injuries among restaurant and food service workers. It is estimated that food service workers have 60% higher rate of occupational injury or illness than workers in other industry. This study investigates effects of asymmetric load carriage at shoulder level on gait characteristics. Each participant walked with a service tray held at shoulder height. Each participant’s gait was analyzed under 3 different load walking conditions, no load walking (NLW), intermediate load walking (ILW) (2.5% BW), and maximum load walking (MLW) (5% BW). We found that participants walked significantly slower with gait cycle time 1.125s versus 1.150 s in MLW compared to NLW(p<0.05). We also found that single limb stance time reduced significantly from 0.706s during NLW to 0.694s during MLW and swing time reduced significantly from 0.89s to 0.86s. This study will help design interventions for falls due to load carriage among food service workers.