The purpose of the Learners Log Book is to document the achievements of the learner in a central repository that will be considered as evidence on the effectiveness of the learning process. It is a 'monitoring tool' that e-tutors use to report on individual learners' progress and it is a way of ensuring that learners:
Are engaged in their learning process.
They are experimenting by doing the tasks subscribed to them by the e-tutor.
Avoid plagiarism because learners have to be engaged on a continuous basis and the informal assessment can therefore be used to ensure consistency with the main formal assessment.
Provide e-Tutors with the opportunity to get to know the learners evaluate them and mentor them properly.
There are templates which will reflect whether learners read, whether they understand, whether they assimilate the knowledge, whether they develop enquiry ability, whether they have the potential to conduct critical thinking and whether they can reflect on the knowledge accumulated by relating to real situations.
The onus is mainly on learners to furnish the required information in the templates after each unit based on the Read and Analyze Activity. After filling the information in the template they need to e-mail it back to the e-Tutor.
e-Tutor will then comments on the work done and the involvement that takes place and give overall impressions on the learners at the end of the module.
III. SUMMARY (200 words)
Provide a summary in your own words on the article you requested to read and analyze in the following space.
The increase in competition and work load within an organization makes the employees a target of Occupational stress and related Occupational diseases (such as cardiovascular diseases, depression, anxiety, low morale etc.). As such the organizations are influenced directly by the state of its human resource. The increase in stress levels causes Organizational anomalies such as rise in absenteeism, low enthusiasm levels during work, lack of concentration and high attrition rate that directly or indirectly affects organization's productivity. Organizational stress causes the U.S. Industry 300 billion dollars a year & U.K. a worth of 353 to 381 million pounds a year (Psychologically Healthy Workplace Program Fact Sheet, 2010). So in order to cope up with the stress issue, the organizations run Workplace Health Promotion (WHP) Programs to gain an insight into what is eating up the employee's productivity. The traditional approach of the WHP is to focus on the individual employees rather than on the environment in which they are working. This approach proved good for short period but it just failed for a larger perspective. The WHP then shifted its attention towards the Comprehensive approach i.e. combining the study of an Individual, Organization and Individual-Organization Communication Channel. This proved much more fruitful than the traditional method of Individual approach.
IV. KEY LEARNING POINTS (100 words)
Identify the key learning points in the read and analyze assigned activity.
Key learning points in article, "The role of workplace health promotion in addressing job stress", are:-
The losses due to Occupational Stress forces the Workplace Health Promotion (WHP) Groups to design an efficient strategy to combat its sources.
They follow either the Individual Approach to Job Stress or the Comprehensive Approach.
They identify the pattern of the Occupational Diseases, Stressful Working Conditions and Absenteeism and the Workplace Stressors such as Adverse Working Conditions, Autocratic Management Styles, and Poor Individual- Organizational Communication.
Based on such statistics, the WHP group introduces the Stress Management initiatives at the individual level and the Organizational level.
V. RELEVANT STATEMENTS TO THE SESSION (100 words)
While you reading, identify the relevant statements to the session and insert them in order in the following space.
The relevant statements to the article "The role of workplace health promotion in addressing job stress" are:
The stress in the workplace is bad not only for the individual workforce but it exerts heavy pressure on the Organizations.
Organizational stress is a consequence of individual employees' behavior, the organizational environment and the individual organizational communication.
The approach to combat job stressors traditionally focused on the method of individual approach such as training them on lifestyle rectification to overcome stress.
The health and safety legislations in countries however demand the management to consider the organizational factors that are responsible for causing stress. So a Comprehensive approach experimentally, is more effective to combating stress.
VI. CRITICAL ANALYSIS (300 words)
This is the most important section in your analysis. To complete it sucessfully, learner is to consider the following guiding steps:
Present arguments coherently, supported by evidence and facts to substantiate on why you may take a particular stance and/ or position towards a particular approach whether against or in support of it;
Capable of bridging the gap between the theory and conceptual work with the application under consideration.
Occupational Stress needs a broader study as the loss statistics are too high. The study of the reasons of Occupational stress in the recent years have shown that training the employees to cope up with stress at an individual level has short term gains on the productivity of the organization. As mentioned in the article "The role of workplace health promotion in addressing job stress", the case study of Opticom is an example. Opticom appointed a manager to the operator assisted services department. The manager recorded a high level of absenteeism (main reason being sick leave). He decided to ask a health promotion company look into the matter. The company decided to approach the individual method that is they held health check ups, monitored the lifestyles of the employees, and gave training to cope up with the challenges. The results were not what were expected. After some time, the evaluation of the program showed very little effect on absenteeism. Later on, when the comprehensive approach was undertaken, employee discussion revealed that there were some organizational conditions such as work redundancy, lack of training to deal with abusive callers, work intensification, inconsistent supervision methods that caused stress. The management after all such considerations, designed the trainings accordingly, made sure of the involvement of employees in the decision making, role ambiguity was dealt with and the results were soon observed with long term effects, the major one being the absenteeism decreased. Also the team came to know about a very unusual problem that the error rate was comparatively high in a specific time of day on the weekdays. The employees were concerned about their children reaching home from school or not. It suggested the management to give time to the employees to make a call to their children. The trick worked and errors decreased.
VII. PRACTICAL IMPLICATIONS (200 words)
Some of the practical implications of health promotion in work are as follows:
In 1997, a study was carried out by the University of Sheffield at the Bradford Metropolitan Council on its employees that were experiencing stress. 41.6% of the staff was under high stress. The initiatives such as Education Pilot survey, Counseling, Stress management action plan were designed according to the staff, Health of Man project, Stress Risk Assessment and life style modification programs were conducted. As a result of such holistic approach, the council is sure to achieve its goal of reduction of stress levels by 25% in the due time (Bradford Metropolitan Council - stress prevention strategy, 2008).
In the 1990's the increase in business pressure among the employees of Glaxo Smithkline (GSK) forced the management to focus on stress management and awareness training. The GSK focussed on individual employees (by providing trainings to gain mental, spiritual, emotional and physical control and maintain the energy.). Along with this on the organizational front, Personal Resilience, Team Resilience programs were conducted that focussed on the business domains that created stress. The efforts of the GSK resulted in the decrease of mental ill health by 60% (globally). Staff satisfaction increased by 21% and 14% increase in willingness to work for the Company (GlaxoSmithKline - stress management).
VIII. LEARNING REFLECTIONS (100 words)
What have you learnt? Critical thinking is about lessons learnt to be drawn from the analysis.
Individual-oriented stress busting approach can give short term benefits to the individual as well as to the organization but to gain a broader perspective, Comprehensive approach that takes into account not only the individual but also the Organizational factors must be adopted. Such stress is a consequence of employee behavior plus the working environment such as work overload, non communication with the management, non existence in the decision making, poor work to reward ratio etc. To manage the employees' work stress to a minimum by following the latest methods, will help not only the employees but also the organizations to increase their productivity and stay ahead in the competition.
XI. REFERENCES
Bradford Metropolitan Council - stress prevention strategy. (2008, March 19). Retrieved October 9, 2012, from http://www.lge.gov.uk: http://www.lge.gov.uk/lge/core/page.do?pageId=119917
GlaxoSmithKline - stress management. (n.d.). Retrieved October 9, 2012, from http://www.dwp.gov.uk: http://www.dwp.gov.uk/health-work-and-well-being/case-studies/gsk-stress/
Psychologically Healthy Workplace Program Fact Sheet. (2010). Retrieved October 8, 2012, from http://www.apa.org: http://www.apa.org/practice/programs/workplace/phwp-fact-sheet.pdf
The Reading
The role of workplace health promotion in
addressing job stress
ANDREW NOBLET1 and ANTHONY D. LAMONTAGNE2
1Deakin Business School, Deakin University, Australia and 2Centre for Health and Society,
University of Melbourne, Australia
SUMMARY
The enormous human and economic costs associated with occupational stress suggest that initiatives designed to prevent and/or reduce employee stress should be high on the agenda of workplace health promotion (WHP) programs. Although employee stress is often the target of WHP, reviews of job stress interventions suggest that the common approach to combating job stress is to focus on the individual without due consideration of the direct impacts of working conditions on health as well as the effects of working conditions on employees' ability to adopt and sustain 'healthy' behaviors'. The purpose of the first part of this paper is to highlight the criticisms of the individual approach to job stress and to examine the evidence for developing strategies that combine both individual and organizational-directed interventions (referred to as the comprehensive approach). There is a risk that WHP practitioners may lose sight of the role that they can play in developing and implementing the comprehensive approach, particularly in countries where occupational health and safety authorities are placing much more emphasis on identifying and addressing organizational sources of job stress. The aim of the second part of this paper is therefore to provide a detailed description of what the comprehensive approach to stress prevention/reduction looks like in practice and to examine the means by which WHP can help develop initiatives that address both the sources and the symptoms of job stress.
Key words: employee well-being; occupational stress; workplace health promotion
Occupational stress is quickly becoming the single greatest cause of occupational disease (Leigh and Schnall, 2000) and can have far reaching consequences for both the worker and the workplace. Occupational stress occurs when external demands and conditions do not match a person's needs, expectations or ideals or exceed their physical capacity, skills, or knowledge for comfortably handling a situation (French et al., 1982). For employees, chronic exposure to stressful situations such as work overload, poor supervisory support and low input into decision making have been cross-sectionally and prospectively linked to a range of debilitating health outcomes, including depression, anxiety, emotional exhaustion, immune deficiency disorders and cardiovascular disease [e.g. (Michael and Williams, 2003; Sapolsky, 2003)]. Stressful working conditions can also have an indirect impact on employee well-being by limiting an individual's ability to make positive changes to lifestyle behaviors' (e.g. smoking, sedentary behavior) or by directly contributing to negative health behaviors' (Landsbergis et al., 1998).
Chronic job stress is also considered to be a major barrier to effective organizational functioning. Occupational stress contributes to a number of outcomes that are critical to organizational success, including absenteeism, labor turnover and job performance [e.g. (Dollard et al., 2000; Michael and Williams, 2003)]. Industry overall has suffered considerable losses as a result of occupational stress and, in the UK alone, job stress has been estimated to cost employers between £353 and £381 million pounds per year (1995/1996 prices) (HSE, 1999). 346 Downloaded from http://heapro.oxfordjournals.org/ by guest on October 3, 2012 The estimated number of days lost due to stress has more than doubled since these calculations were undertaken (Jones etal., 2003) and, in an era of heightened downsizing, work intensification and resource rationalization, this trend appears set to continue (Sparks et al., 2001).
The human and economic costs of job stress strongly suggest that it is in everybody's interest employees, employers and the community at large-that stress prevention/reduction initiatives are high on the agenda of any workplace health promotion (WHP) programme. Whilst there is evidence that employee stress is often the target of WHP, reviews of job stress interventions indicate that the strategies used to combat stress at work are generally limited to the individual-orientated approach (EASHW, 2002; Giga et al., 2003; Caulfield et al., 2004).
This approach has been widely condemned and the first half of this paper will outline the major criticisms that have been directed at strategies that focus solely on individual employees. This section will also examine the impact of work based sources of stress and outline the benefits of adopting a more comprehensive set of initiatives that simultaneously address the worker and the workplace. The remainder of this paper will then examine the role that WHP practitioners can play in developing comprehensive job stress prevention programs.
INDIVIDUALLY ORIENTED STRESS
MANAGEMENT PROGRAMS
Worker-directed WHP strategies typically focus on the health-related attitudes and behaviors' of individual employees and aim to provide them with information and guidance on how to adapt to, or manage, the pressures and demands faced in everyday work life. Stress management interventions that target the individual include one-to-one counseling, relaxation training, lifestyle education and other behavior change strategies (Giga et al., 2003). This approach to combating the ill-effects of job stress is reflective of the traditional model of WHP that has focused almost exclusively on individual lifestyle behaviors', such as smoking, diet and exercise, with little or no consideration of the contribution that job conditions make to such behaviors' or the direct contributions that adverse working conditions can make to 'lifestyle-related' diseases such as heart disease and cancer (LaMontagne, 2004).
This individual-orientated approach to job stress has been strongly criticized by organizational health practitioners, employee representatives and occupational stress researchers. Before examining the specific criticisms that have been directed at this approach, a case study has been provided to illustrate the major weaknesses of individually orientated stress management strategies (Box 1) (Noblet, 2004).
The Opticom case study is a typical example of where an organization has used the individual approach to develop initiatives that Baric describes as undertaking 'health promotion in a setting' (Baric, 1993). The majority of initiatives were aimed at identifying individuals who are at risk of developing lifestyle-related diseases (e.g. cardiovascular disease), and encouraging them to adopt healthier lifestyles. The health impact of the setting itself-including social, organizational and physical conditions-was largely overlooked.
CRITICISMS OF THE INDIVIDUAL
APPROACH
There are three main criticisms that have been directed at stress prevention programs that are driven by the individual perspective. First,
Box 1: Case study (part 1). The operator-assisted services (OAS) section of Opticom is a 24 h call centre located in the Central Business District of a large Australian city. Approximately 200 employees are employed across three shifts to attend to local and international enquiries. Opticom recently appointed a new manager to the OAS unit who, in her first review of the unit's operations, found that it was experiencing high absenteeism (most of which was sick leave), increasing customer complaints and low morale. Anecdotal evidence from a number of employees also suggested that stress levels were high. The manager was determined to reduce the high rates of sick leave and immediately sought the services of a corporate health promotion company. This company introduced a series of health checks and follow-up counselling covering such issues as diet, blood pressure, fitness and stress. In the case of stress, all staff were also given the opportunity to attend relaxation classes twice a week. After 6 months, an evaluation of the programme revealed that it had very little impact on absenteeism. While the screening sessions held during work hours were well attended, the relaxation classes were not. WHP and job stress 347 Downloaded from http://heapro.oxfordjournals.org/ by guest on October 3, 2012 several authors have been highly critical of the practice of focusing on individual employees whilst ignoring the influence of adverse working conditions [e.g. (Corneil and Yassi, 1998; Daykin, 1998)]. The European Agency for Safety and Health at Work reports that individual symptoms of stress are often manifestations of organizational-level problems rather than personal coping deficiencies (EASHW, 2002). Thus, by trying to teach employees to cope with stressful working conditions, proponents of this approach can be seen to be blaming the victim of poor communication channels, inadequate training, autocratic management styles and other common sources of workplace stress. The second criticism often directed at the individual-oriented approach is that strategies aimed at helping people to cope with stressful working conditions, without addressing those conditions, contravene the occupational health and safety legislation that exists in many industrialized countries, including Australia, Canada, the European Union member states, Hong Kong, Malaysia, New Zealand, the UK and the United States (Chu and Dwyer, 2002; Cousins et al., 2004). In the UK, for example, employers must monitor both physical and psychosocial hazards and, as a result, a failure to address adverse working conditions, so far as is reasonably practical, is a breach of that legislation (Mackay et al., 2004). Overlooking the work-based sources of poor health is also a breach of internationally recognized health promotion and public health principles. The Ottawa Charter for Health Promotion (WHO, 1986) and the Luxembourg
Declaration on Workplace Health Promotion in the European Union (ENWHP, 1997), for example, both emphasize the need to address the social, economic and environmental determinants of health. Ignoring these principles is not considered unlawful; however, it does contravene best practice in health promotion. The final major criticism directed at the worker oriented stress prevention strategies is that they often fail to achieve any significant health and/or productivity outcomes. Research examining the outcomes associated with employee-centered strategies have found that, where benefits have been identified, such strategies tend to result in shorter-term psychological benefits are not sustainable over a longer period and have little impact on organizational effectiveness [e.g. (Pelletier et al., 1999; Whatmore et al., 1999)].
Overall the criticism that has been directed at this approach indicates that individually focused stress prevention programs are ethically unsound, are not supported by OHS legislation or health promotion principles, and generally fail to deliver sustainable benefits for either the employee or the organizations for which they work.
MOVING TOWARDS A
COMPREHENSIVE APPROACH
Despite the criticisms directed at stress prevention programs that focus exclusively on the health-related attitudes and actions of individual employees, worker-directed initiatives can still make valuable contributions to combating stress at work. Comprehensive stress prevention programs, which address both the organizational origins of stress at work as well as the symptoms of distress exhibited by individual employees, are much more likely to lead to favourable, long-term outcomes than programs that focus solely on the individual [e.g. (Kompier et al., 2000; Michael and Williams, 2003)]. As acknowledged by Bond, comprehensive programs provide a balance between organizational and individual-directed interventions that ensure that '. . . preventative benefits of the former can have a widespread impact across an organization, whilst the curative strengths of the latter can target those (fewer) people who have already succumbed to occupational ill-health' [(Bond, 2004), p.147]. The benefits of comprehensive stress prevention programs include outcomes that are relevant to the individual (e.g. enhanced psychological health, improved job satisfaction, reduction in ambulatory blood pressure) as well as the organization (e.g. reduced sickness absence, increased organizational commitment, improved job performance). When compared with traditional lifestyle education/counseling programs, comprehensive WHP initiatives are also much more likely to capture the involvement of low-paid blue-collar workers-a group that traditional lifestyle risk programs had previously found difficult to reach-and to result in successful behavior change (Sorensen et al., 2002).
In health promotion terms, comprehensive stress prevention/reduction initiatives reflect the settings approach to promoting health at work (Chu et al., 2000; Noblet, 2003). A hallmark of the settings approach is the attention given to 348 A Noblet and A D LaMontagne Downloaded from http://heapro.oxfordjournals.org/ by guest on October 3, 2012monitoring and addressing the impact that the setting itself has on the health of employees. In the case of job stress, this includes a close examination of the social and organizational conditions that contribute to job stress (Polanyi et al., 2000).
The following section will summarize the common sources of job stress and will highlight the relationship between a number of the more influential stressors and measures of individual and organizational health.
ORGANIZATIONAL SOURCES OF
JOB STRESS
There is considerable variation in the way individuals perceive and respond to the environments in which they work. Descriptions of the stress process indicate that personal (e.g. coping skills) and situational (e.g. support from supervisors) variables will influence the onset and duration of job stress and what one person finds demanding and stressful others may perceive as challenging and stimulating (Cooper et al., 2001).
Despite this variation at the individual level, at the population level (i.e. on average across all individuals) a range of physical, social, organizational and economic conditions have been identified as common sources of job stress (Cox and Cox, 1993). These conditions, referred to as job stressors, are the physical, social, organizational or economic conditions at work that contribute to stress. Job stressors can result from the job itself (e.g. heavy workloads, low input into decision-making) or the social and organizational contexts in which the job is performed (e.g. poor communication, interpersonal conflict). Although there are a range of organizational based situations and conditions that often contribute to job stress, several of these variables are thought to play particularly salient roles in the onset and severity of job stress. These variables are captured in two models of job stress that have dominated the occupational health psychology literature over the past two decades- Karasek and Theorell's (Karasek and Theorell, 1990) Demand-Control-Support (DCS) model and the Siergest's Effort-Reward Imbalance (ERI) model. In the DCS model, high levels of job stress occur when the demands of the job are not matched by adequate levels of decision making authority and/or support from supervisors and colleagues (Karasek and Theorell, 1990). Research has consistently demonstrated that the DCS component variables-particularly job control and social support-are predictive of health and performance outcomes (e.g. sickness absence) [e.g. (Bond and Bunce, 2003; De Lange et al., 2004)]. In the case of Siegrist's effort/ reward imbalance (ERI) model, high cost/low gain conditions (i.e. high effort and low reward) have been found to be particularly stressful (Siegrist, 2002). The DCS and ERI overlap to some extent, but also have complementary, independent relationships with adverse health outcomes [e.g. (Kivimaki et al., 2004)]. Taken as a whole, these two models have identified specific working conditions that can have particularly serious consequences for the mental and physical health of working people
After the corporate health programme was found to have little impact on the health and performance of operator-assisted services (OAS) employees at Opticom, informal discussions with employees found there were a number of organizational factors that were particularly stressful for workers. Part 2 of the Opticom case study (Box 2) indicates that conditions such as heavy quantitative workloads, lack of variety, interpersonal conflict, inadequate training and development, and unpredictable and often unsupportive supervisory styles were likely to be key sources of stress for employees. The literature presented in the preceding section clearly indicates that the adverse conditions experienced by Opticom staff are not unique to this particular organization. Furthermore, the far-reaching health consequences of long-term exposure to these situations support the view that working condition, particularly those reflected in the widely tested Box 2: Case study (part 2)
There are many problems inherent within the OAS unit. The task of attending to public enquiries is extremely repetitive. In the domestic section, for instance, operators would receive on average of 175 calls per 8 h day, with each lasting between 30 s and 5 min. They often have to attend to irate and sometimes abusive callers and receive next to no training in dealing with this sort of conflict. There is a top-down style of management and operators have virtually no say in decisions directly affecting what they do, despite the fact that they are generally in the best position to identify problems and generate ideas for overcoming them. Exacerbating the situation is an unpredictable style of supervision that swings erratically from overbearing to non-existent. WHP and job stress 349 Downloaded from http://heapro.oxfordjournals.org/ by guest on October 3, 2012 job stress models, need to become a high priority for WHP practitioners.
The first part of this paper has provided considerable evidence supporting the development of comprehensive stress prevention/ reduction strategies. Whilst proponents of comprehensive stress prevention programs call for a dual individual-organizational approach to be adopted, there is a risk that the recent push for organizations to focus much more heavily on psychosocial and organizational hazards, may result in an overemphasis on organizational strategies.
This perception is supported by Bond who expressed concern that individual-oriented strategies have been assigned a negligible role in the UK Management Standards and that their value may be lost in an 'organizationally focused, intellectual milieu' [(Bond, 2004), p.146]. This situation is often not the fault of OHS authorities themselves, as they have been legislated to address workplace determinants of health and are severely limited in their ability to advise/assist organizations to address 'lifestyle' factors (Eakin, 2000). Nevertheless, there has been a shift in the dominant stress prevention/reduction approach promoted by OHS authorities and there is a risk that practitioners may begin to underestimate or even ignore the value of combined individual- organizational initiatives (Kompier, 2004; Walls and Darby, 2004). This risk is particularly true for WHP practitioners, who may be more familiar with education and behavior change strategies, and feel ill-equipped to help identify and address organizationally based stressors. Such people (and even the organizations for which they work) may begin to ignore occupational stress, believing that they have a limited capacity to address this issue. The overall aim of the second part of the present paper is therefore to provide a more practically oriented description of the comprehensive approach to stress prevention and to demonstrate how WHP practitioners can facilitate the shift from an approach that focuses almost solely on the individual, to one that examines and addresses both the individual and the organizational sources of ill-health.
COMPREHENSIVE, SETTINGS-BASED
INTERVENTIONS AND THE
IMPLICATIONS FOR WHP
A conceptual framework that mirrors the settings approach to health promotion and which can be used to develop comprehensive stress prevention strategies is DeFrank and Cooper's typology of job stress interventions (DeFrank and Cooper, 1987). DeFrank and Cooper classified interventions according to the level in the organization that the strategy targeted: the individual employee, the organization and the organization-individual interface. The typology has been used to categorize and review occupational stress prevention programs and can provide WHP practitioners with valuable insights into the types of settings-based interventions that can be used to prevent/reduce job stress (Giga et al., 2003). The following section provides a more detailed description of the three intervention levels and the action that WHP practitioners can take to facilitate the development and implementation of strategies within each level. The aim of individual-level interventions is to equip people with the knowledge, skills and resources to cope with stressful conditions- whether they are showing stress-related signs and symptoms or not. At this level, WHP programs need to cover a range of strategies, including training in relaxation, biofeedback and meditation, as well as time management, goal setting and other coping techniques that aim to alter the way in which people structure and organize their working and non-working lives.
The second level of stress intervention refers to the interface between the individual and the organization and targets issues such as role ambiguity, relationships at work, person- environment fit and employee involvement in decision-making. Examples of specific individual-organization level strategies include co-worker support groups, role clarification processes and participatory decision-making programs. WHP has a major role to play in planning and developing these strategies.
Individual-organization initiatives must be based on a sound understanding of the specific psychosocial conditions impacting on worker health (Bond and Bunce, 2001). WHP practitioners therefore need to first ensure managers and supervisors are equipped with the knowledge and skills to identify these problematic issues. They then need to help design initiatives that can clarify the ambiguity, reduce the conflict and generally overcome the source of the stress. The third level of interventions addresses areas in the physical, organizational and social environments that may produce stress. Interventions that target the organization include job 350 A Noblet and A D LaMontagne Downloaded from http://heapro.oxfordjournals.org/ by guest on October 3, 2012 redesign strategies, selection and placement and organizational development programs.
Again, the role of WHP at this level is to enhance the organization's capacity to identify and assess the specific conditions that are contributing to employee stress and to work with all levels of the organization to help develop strategies that can eliminate/reduce their impact. Whilst some high-performing organizations may embrace comprehensive stress prevention programs as a way of improving organizational functioning, there is evidence that many organizations may be unaware, or even reluctant to acknowledge, the relationship between working conditions and employee health and performance (Mustard, 2004). Another key aim of WHP may therefore be to help raise awareness of the work-health relationship, particularly among senior managers, and to highlight the possible consequences of addressing (or not addressing) organizational sources of job stress. In settings where WHP practitioners encounter resistance to addressing job stressors, they might begin strategically by considering both work and non work
(e.g. child care issues, as illustrated in the Opticom case) sources of stress, and incrementally shift the focus to work-related sources as trusting relationships develop (Eakin, 2000).
Part 3 of the Opticom case study (Box 3) is a good example of where all three levels of job stress interventions have been implemented simultaneously. In the end, the individual focused efforts of the external WHP practitioners were coordinated with and complemented by management efforts to reorganize the job tasks. The work schedule was modified to better accommodate the non-work commitments of employees (organizational-level intervention), employees were involved in the decision-making processes that lead to the development of the new strategies (individual-organizational level intervention) and employees were given the opportunity to develop and apply relaxation skills that could help them cope with stressful conditions and events (individual-level intervention). The involvement of employees in identifying and addressing their own needs reflects the empowerment approach to health promotion and has enhanced the ability of the organization to address other workplace stressors (i.e. erratic supervision, poor conflict resolution skills and monotonous workloads). In addition, OAS now has a structure (i.e. coordinating committee) and system (i.e. employee and organizational needs assessment) in place to monitor, modify and manage these stressors.
CONCLUSION
The pressures associated with increasingly competitive and cost-conscious marketplaces will continue to place enormous demands on organizations and their members. Excessive job stress is therefore an issue that is likely, at some stage, to impact on the lives of all employees, irrespective of their position in the organization or the industry in which they work. The stress prevention research clearly recognizes that whilst individual-level strategies can offer short-term solutions, the settings approach to health promotion provides a more effective and sustainable framework for addressing the sources and symptoms of job stress. Practitioners involved in developing WHP programs therefore need to advocate for more comprehensive, settings based initiatives to be developed. The job stress intervention literature also recognizes that there are numerous ways in which health promotion professionals can help plan and implement higher level strategies that target the psychosocial and organizational sources of job stress. Box 3: Case study (part 3) After Opticom realized that its strategies had not worked, it decided to undertake a more inclusive and systematic investigation into why OAS was not performing as well as it should. A small committee, consisting of management and employee representatives, was formed to guide and oversee this assessment. The committee quickly found that the unit's performance fluctuated significantly and a period when error rates were particularly high was midafternoon on a weekday. Informal discussions with a cross-section of employees later found that a major source of poor performance was mothers worrying about whether their children had got home from school safely. OAS employed a large number of mothers with dependent children and action needed to be taken to address their needs. Through the ideas generated by employees, Opticom gave their operators a 10 min break around 4 p.m. so they could call home to make sure that the kids had arrived safely. This strategy alone resulted in a significant improvement in the service quality and morale. The timing of the relaxation classes was also changed to better accommodate the work and personal commitments of employees. WHP and job stress 351 Downloaded from http://heapro.oxfordjournals.org/ by guest on October 3, 2012 given the limitations of individual-level strategies, practitioners must take advantage of these opportunities.
