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Studying gradients in occupational health among hospital workers (GROW Study): Challenges and adaptations

Deborah R. Gordon, PhD, Department of Anthropology, History and Social Medicine, University of California, San Francisco, 3333 California Street, Suite 485, San Francisco, CA 94143-0850, 415-383-1364, dgordon@itsa.ucsf.edu, Marion Gillen, RN, MPH, PhD, Dept. of Community Health Systems, UCSF School of Nursing, Box 0608, San Francisco, CA 94143-0608, Irene Yen, PhD, Institute for Health and Aging, UCSF School of Nursing, San Francisco, CA, Louise Swig, UC San Francisco, 1600 Divisadero Street, C 4444, San Francisco, CA 94115, Genevieve M. Ames, PhD, Pacific Institute for Research and Evaluation, Prevention Research Center, 2150 Shattuck Avenue, Suite 900, Berkeley, CA 94704, Ira Janowitz, PT, CPE, Ergonomics Program, University of California, San Francisco/Berkeley, 1301S. 46th St., Building 163, Richmond, CA 94804, and Paul D. Blanc, MD, MSPH, Department of Medicine, University of California - San Francisco, 350 Parnassus Avenue, Suite 609, San Francisco, CA 94134.

Hospital workers are often exposed to many ‘hazards’ --physical, emotional, social, and moral-- that can make them vulnerable to work-related injuries, disorders and illnesses of many types. The social and economic significance of these health problems, together with the heterogeneity of occupations, education, pay, and working conditions, offer a rich terrain to investigate gradients of health among workers in the same institution. The GROW Study, Gradients in Occupational Health in Hospital Workers (National Institute of Arthritis and Musculoskeletal and Skin Diseases, RO1 AR47798-01), seeks quantitative and qualitative insights into health gradients by studying how both micro and macro workplace factors relate to differences in health outcomes, in particular, work-related musculoskeletal disorders, across job categories in two hospitals in a metropolis in western USA. Reflecting the multi-factoral nature of these illness and injury processes, this multi-disciplinary study has 4 arms: epidemiologic; ergonomic; ethnographic/qualitative; and community outreach and education.

Putting research proposal into action in two very different social and organizational work environments --70% of 700 survey subjects and 50 people in the qualitative recruited--required strategic decisions and adjustments. In addition to the usual challenges of achieving access, recruitment, and retention are challenges of constructing a survey instrument and carrying out a research design that is multi-disciplinary, comprehensive, yet not overly demanding for the subjects; gaining trust and candor among marginal worker populations; harmonizing practices of confidentiality and informed consent; adapting interview techniques to workers with little time and unpredictable work schedules, and gaining entree to groups in political conflict.

Learning Objectives:

Keywords: Health Disparities, Health Care Workers

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Health Disparities Research in the Work Environment: Opportunities and Obstacles

The 132nd Annual Meeting (November 6-10, 2004) of APHA