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  • 1.
    Aronsson, Vanda
    et al.
    Stockholm Univ.
    Toivanen, Susanna
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Stockholm Univ, Dept Publ Hlth Sci, Stockholm, Sweden..
    Leineweber, Constanze
    Stockholm Univ, Stress Res Inst, S-10691 Stockholm, Sweden..
    Nyberg, Anna
    Stockholm Univ, Stress Res Inst, S-10691 Stockholm, Sweden..
    Can a poor psychosocial work environment and insufficient organizational resources explain the higher risk of ill-health and sickness absence in human service occupations?: Evidence from a Swedish national cohort2019In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 47, no 3, p. 310-317Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of this study was to investigate differences in burnout, self-rated health (SRH) and sickness absence between human service occupations (HSOs) and other occupations, and whether they can be attributed to differences in psychosocial work environment and organizational resources. Methods: Data were derived from the Swedish Longitudinal Occupational Survey of Health, an approximately representative sample of the Swedish working population (n = 4408). Employment in HSOs, psychosocial work environment and organizational resources in 2012 predicted relative risks of sickness absence, burnout and suboptimal SRH in 2014 using modified Poisson regressions. The psychosocial work factors' and organizational resource variables' relative importance were estimated by adding them to the models one by one, and with population attributable fractions (PAFs). Results: Employment in HSOs was associated with a higher risk of sickness absence and the risk was explained by psychosocial and organizational factors, particularly high emotional demands, low work-time control and exposure to workplace violence. Employment in HSOs was not associated with burnout after sociodemographic factors were adjusted for, and furthermore not with SRH. A lower risk of suboptimal SRH was found in HSOs than in other occupations with equivalent psychosocial work environment and organizational resources. PAFs indicated that psychosocial work environment and organizational resource improvements could lead to morbidity reductions for all outcomes; emotional demands were more important in HSOs. Conclusions: HSOs had higher risks of sickness absence and burnout than other occupations. The most important work factors to address were high emotional demands, low work-time control, and exposure to workplace violence.

  • 2.
    Backlander, G
    et al.
    Swedish Sch Sport & Hlth Sci, Stockholm, Sweden.
    Falten, R
    Stockholm Univ, Dept Psychol, Stockholm, Sweden.
    Danielsson, C B
    KTH Royal Inst Technol, Sch Architecture, Stockholm, Sweden.
    Toivanen, Susanna
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Richter, A
    Swedish Sch Sport & Hlth Sci, Stockholm, Sweden.
    Development and Validation of a Multi-Dimensional Measure of Activity-Based Working Behaviors2021In: Frontiers in Psychology, E-ISSN 1664-1078, Vol. 12Article in journal (Refereed)
    Abstract [en]

    Most work on activity-based working centers on the physical environment and digital technologies enabling flexible working. While important, we believe the key components for implementing activity-based working are employee and manager behaviors. To measure the degree of enactment of activity-based work, based on workshops with experienced practitioners as well as previous literature, we have developed and validated a behavior-focused measure of activity-based working behaviors. In our initial sample (Sample 1, N = 234), three subscales were identified: task - environment crafting, workday planning, and social needs prioritization. In the replication sample (Sample 2, N = 434), this model also showed adequate fit. Moreover, task - environment crafting was related to general health and lower stress in sample 1 (multi-organization sample), but not in the single-organization sample (sample 2). Workday planning was associated with higher concentration in both samples and in the second sample with general health and work engagement; the latter was also related to social needs prioritization.

  • 3.
    Bergman, Louise E.
    et al.
    Stockholm University, Sweden.
    Bernhard-Oettel, Claudia
    Stockholm University, Sweden.
    Bujacz, Aleksandra
    Karolinska Inst, Dept Clin Neurosci, Div Psychol, Solna, Sweden..
    Leineweber, Constanze
    Stockholm University, Sweden.
    Toivanen, Susanna
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Comparing Depressive Symptoms, Emotional Exhaustion, and Sleep Disturbances in Self-Employed and Employed Workers: Application of Approximate Bayesian Measurement Invariance2021In: Frontiers in Psychology, E-ISSN 1664-1078, Vol. 11, article id 598303Article in journal (Refereed)
    Abstract [en]

    Studies investigating differences in mental health problems between self-employed and employed workers have provided contradictory results. Many of the studies utilized scales validated for employed workers, without collecting validity evidence for making comparisons with self-employed. The aim of this study was (1) to collect validity evidence for three different scales assessing depressive symptoms, emotional exhaustion, and sleep disturbances for employed workers, and combinators; and (2) to test if these groups differed. We first conducted approximate measurement invariance analysis and found that all scales were invariant at the scalar level. Self-employed workers had least mental health problems and employed workers had most, but differences were small. Though we found the scales invariant, we do not find them optimal for comparison of means. To be more precise in describing differences between groups, we recommend using clinical cut-offs or scales developed with the specific purpose of assessing mental health problems at work.

  • 4. Bernhard-Oettel, Claudia
    et al.
    Bergman, Louise
    Leineweber, Constanze
    Toivanen, Susanna
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Flourish, fight or flight: Health and well-being in self-employment over time-associations with business success2019Conference paper (Refereed)
    Abstract [en]

    Purpose: Around 9% of the working population in Sweden consists of self-employed business owners, but a considerable amount of them struggle to consolidate or expand their businesses. Among the factors predicting business success the decisive role of long-term health of business owners has been acknowledged only recently, but longitudinal studies testing this assumption are scarce. Based on the conservation of resources theory, good health can be seen as a resource that helps business owners to tackle high workloads and make business succeed.Design: Data from the Swedish Longitudinal Occupational Health Survey is used. Starting in 2012, N= 554 self-employed have answered three or more times in the biannual data collection. Latent growth curve modelling is employed to study general and mental health trajectories and their associations with business survival over time.Results: Preliminary descriptive analyses on biannual changes suggest that roughly one in ten self-employed leaves self-employment at follow-up. Job demands and emotional exhaustion are higher among those who leave compared to those who remain in business. After integrating new data collected in 2018, growth curve analyses are run over the whole longitudinal sample, and associations of health trajectories to business survival will be tested.Limitations: Data is collected with questionnaires, and business success is operationalized as business survival only.

  • 5.
    Bernhard-Oettel, Claudia
    et al.
    Department of Psychology, Stockholm University, Stockholm, Sweden.
    Bergman, Louise
    Department of Psychology, Stockholm University, Stockholm, Sweden.
    Leineweber, Constanze
    Department of Psychology, Stockholm University, Stockholm, Sweden.
    Toivanen, Susanna
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Flourish, fight or flight: health in self-employment over time—associations with individual and business resources2024In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246Article in journal (Refereed)
    Abstract [en]

    PurposeUsing COR theory to study developments of health and other key resources in self-employed workers in Sweden over 6 years, this study: (1) explored whether the heterogenous group of self-employed workers contained subgroups with different health trajectories, (2) investigated whether these were more typical for certain individuals (with respect to age, gender, sector, education, employment status), and (3) compared the different health trajectories regarding resource development in mental well-being, business resources, employment status, work ability.

    MethodThe study used data from the Swedish longitudinal occupational survey of health (SLOSH) and included participants working as self-employed or combiner (N = 2642).

    ResultFive trajectories were identified with latent class growth curve model analysis (LCGM). Two health trajectories with (1) very good, respective (2) good stable health (together comprising 78.5% of the participants), (3) one with moderate stable health (14.8%), (4) one with a U-shaped form (1.9%), and (5) one with low, slightly increasing health (4.7%). The first two trajectories flourish: they maintained or increased in all key resources and were more likely to remain self-employed. Trajectories three and five consist of those who fight to maintain or increase their resources. Workers in the U-shaped health trajectory show signs of fight and flight after loss in health and other key resources.

    ConclusionsStudying subgroups with different resource developments over time was suitable to understand heterogeneity in self-employed workers. It also helped to identify vulnerable groups that may benefit from interventions to preserve their resources.

  • 6.
    Berthelsen, Hanne
    et al.
    Malmo Univ, Ctr Work Life & Evaluat Studies, Malmo, Sweden..
    Muhonen, Tuija
    Malmo Univ, Ctr Work Life & Evaluat Studies, Malmo, Sweden..
    Toivanen, Susanna
    Mälardalen University, School of Health, Care and Social Welfare. Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    What happens to the physical and psychosocial work environment when activity-based offices are introduced into academia?2018In: Journal of Corporate Real Estate, ISSN 1463-001X, E-ISSN 1479-1048, Vol. 20, no 4, p. 230-243Article in journal (Refereed)
    Abstract [en]

    There is an increased interest for introducing activity-based offices at universities. The purpose of this study is to contribute to the knowledge about the importance of the built environment for the psychosocial work environment within academia by analyzing how staff at a large Swedish university experienced the physical and psychosocial work environment before and after moving to activity-based offices. Design/methodology/approach A Web-based survey was distributed to all employees at two faculties at a university three months before (2015, n = 217, response rate 51 per cent) and nine months after (2016, n = 200, response rate 47 per cent) relocation to a new activity-based university building. Findings In the new premises, a vast majority (86 per cent) always occupied the same place when possible, and worked also more often from home. The social community at work had declined and social support from colleagues and supervisors was perceived to have decreased. The participants reported a lower job satisfaction after the relocation and were more likely to seek new jobs. No aspects in the physical or psychosocial work environment were found to have improved after the relocation. Research/limitations implications The study had a two-wave cross-sectional design, which does not allow establishing causal relations. Practical implications There is reason to be cautious about relocation to activity-based offices at universities. The potential savings in costs for premises may lead to may be followed by an increase in other costs. The risk that staff cannot concentrate on their work in activity-based university workplaces and lose their sense of community with colleagues are factors, which in the long run may lead to decreased efficiency, more conflicts and poorer well-being. Originality/value This paper contributes with new knowledge concerning changes in the physical and psychosocial work environment when relocating from cell offices to activity-based offices in a university setting.

  • 7.
    Björklund, Christina
    et al.
    Karolinska Institutet, Sweden.
    Toivanen, Susanna
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Rudolfsson, Lisa
    Karolinska institutet, Sweden.
    Gender-based harassment among university students in Sweden during Covid-192022Conference paper (Refereed)
    Abstract [en]

    This presentation analyses gender-based harassment in terms of bullying and sexual harassment among university students within the academy sector in Sweden. Bullying and harassment are severe risk factors in the psychosocial work environment, affecting both performance and health. This study is part of a collaboration program between four universities in Sweden with the aim to create research-based knowledge for the prevention of gender-based harassment (GBH) in Swedish academia.

    This study was conducted during Covid-19. Preliminary results show that GBH is more prevalent among university students than among staff. In total, 4.8 percent of university students in Sweden state that they have been subjected to sexual harassment (SH) at the university during the last 12 months. Among women, a larger proportion state that they have been exposed (5.7 %), compared to men (3.2 %). A pilot study prior to the larger prevalence study was conducted in the fall of 2020, an early stage of Covid-19. In the pilot study, 7 percent of university students (women 9.1%; men 3.1%) stated that they had been subjected to SH during the last 12 months. Consequently, results show a decrease in SH, especially among women. Furthermore, in the large-scale prevalence study one question asked respondents if Covid-19 had increased or decreased their vulnerability. Results show that about 11 percent of the women reported that exposure had decreased during Covid-19.

    Regarding methodological considerations, a previous review study shows that students exposed to SH seldom file official reports but they frequently face a variety of mental and physical health consequences. Also, how questions about sexual harassment are stated most likely affects response rates among university students. To work for a sustainable and inclusive working life free from gender-based harassment, we need to continue to monitor the development over time in the academia in Sweden.

  • 8.
    Bujacz, Aleksandra
    et al.
    Karolinska Institutet, Stockholm, Sweden.
    Eib, Constanze
    Uppsala University, Uppsala, Sweden.
    Toivanen, Susanna
    Mälardalen University, School of Health, Care and Social Welfare. Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    Not All Are Equal: A Latent Profile Analysis of Well-Being Among the Self-Employed2020In: Journal of Happiness Studies, ISSN 1389-4978, E-ISSN 1573-7780, Vol. 21, no 5, p. 1661-1680Article in journal (Refereed)
    Abstract [en]

    This study uses a person-centered approach to distinguish between subpopulations of self-employed individuals using multidimensional well-being indicators. Data were obtained from European Social Survey including a sample of 3461 self-employed individuals from 29 European countries. The analysis has empirically identified six distinct profiles named ‘unhappy’, ‘languishing’, ‘happy’, ‘satisfied’, ‘passionate’, and ‘flourishing’. The profiles were associated with significant differences in well-being, health and work-related variables. The results highlight the heterogeneity of the self-employed population, and describe the complex—both hedonic and eudaimonic—character of the well-being concept in this population.

  • 9.
    Bälter, O.
    et al.
    Department of Media Technology and Interaction Design, KTH—Royal Institute of Technology, Stockholm, Sweden.
    Hedin, B.
    Department of Media Technology and Interaction Design, KTH—Royal Institute of Technology, Stockholm, Sweden.
    Tobiasson, Helena
    Department of Media Technology and Interaction Design, KTH—Royal Institute of Technology, Stockholm, Sweden.
    Toivanen, Susanna
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Walking outdoors during seminars improved perceived seminar quality and sense of well-being among participants2018In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 15, no 2, article id 303Article in journal (Refereed)
    Abstract [en]

    Low levels of physical activity and sedentary behaviour are a growing health problem globally. Physical inactivity is associated with increased risk of numerous ailments, cardiovascular disease and mortality. Our primary aim was to perform a feasibility study on how to incorporate physical activity among students and teachers in regular teaching activities. The second aim was to investigate how students and teachers perceived the differences between outdoor walking seminars and regular indoor seminars. By transforming an on-campus course into a blended course, we were able to conduct seminars outdoors in nearby nature while walking. These walking seminars were evaluated among 131 students and nine teachers leading the walking seminars. The responses to the student survey and teacher interviews indicate that discussions, sense of well-being and the general quality of the seminar improved, regardless of how physically active participants were the rest of the time. The study shows one way to increase physical activity with small means; in our case, a reorganization of how we prepared for the seminars which allowed for walking discussions.

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  • 10.
    Canivet, Catarina
    et al.
    Lund University, Sweden.
    Bodin, Theo
    Emmelin, Maria
    Lund University, Sweden.
    Toivanen, Susanna
    CHESS, (Centre for Health Equity Studies), Stockholm, Sweden.
    Moghaddassi, Mahnaz
    Lund University, Sweden.
    Östergren, Per-Olof
    Lund University, Sweden.
    Precarious employment is a risk factor for poor mental health in young individuals in Sweden: a cohort study with multiple follow-ups.2016In: BMC Public Health, E-ISSN 1471-2458, Vol. 16, article id 687Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The globalisation of the economy and the labour markets has resulted in a growing proportion of individuals who find themselves in a precarious labour market situation, especially among the young. This pertains also to the Nordic countries, despite their characterisation as well developed welfare states with active labour market policies. This should be viewed against the background of a number of studies, which have shown that several aspects of precarious employment are detrimental to mental health. However, longitudinal studies from the Nordic region that examine the impact of precarious labour market conditions on mental health in young individuals are currently lacking. The present study aims to examine this impact in a general cohort of Swedish young people.

    METHODS: Postal questionnaires were sent out in 1999/2000 to a stratified random sample of the Scania population, Sweden; the response rate was 58 %. All of those who responded at baseline were invited to follow-ups after 5 and 10 years. Employment precariousness was determined based on detailed questions about present employment, previous unemployment, and self-rated risk of future unemployment. Mental health was assessed by GHQ-12. For this study individuals in the age range of 18-34 years at baseline, who were active in the labour market (employed or seeking job) and had submitted complete data from 1999/2000, 2005, and 2010 on employment precariousness and mental health status, were selected (N = 1135).

    RESULTS: Forty-two percent of the participants had a precarious employment situation at baseline. Labour market trajectories that included precarious employment in 1999/2000 or 2005 predicted poor mental health in 2010: the incidence ratio ratio was 1.4 (95 % CI: 1.1-2.0) when excluding all individuals with mental health problems at baseline and adjusting for age, gender, social support, social capital, and economic difficulties in childhood. The population attributable fraction regarding poor mental health in the studied age group was 18 %.

    CONCLUSIONS: This study supported the hypothesis that precarious employment should be regarded as an important social determinant for subsequent development of mental health problems in previously mentally healthy young people.

  • 11.
    Carnesten, Hillewi
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    von Heideken Wågert, Petra
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Wiklund Gustin, Lena
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. The Arctic University of Norway Narvik Norway.
    Toivanen, Susanna
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Skoglund, Karin
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Jaarsma, Tiny
    Department of Health, Medicine and Caring Sciences Linköping University Linköping Sweden;Julius Center University Medical Center Utrecht Utrecht Netherlands.
    Andreae, Christina
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Centre for Clinical Research Sörmland Uppsala University Eskilstuna Sweden.
    Struggling in the dehumanized world of COVID—An exploratory mixed‐methods study of frontline healthcare workers' experiences2024In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, p. 1-15Article in journal (Refereed)
    Abstract [en]

    Aim

    To explore healthcare workers' experiences of the changed caring reality during the COVID-19 pandemic in Sweden.DesignAn online fully mixed-methods design.MethodsA web-based self-reported questionnaire with fixed and open-ended answers collected data from March to April 2021, analysed in three steps. First, free-text questions were analysed by qualitative content analysis. Then quantitative linear regression analyses using models covering stress and coping mechanisms were conducted. Finally, a meta-inference of qualitative and quantitative data emerged a new comprehensive understanding. The COREQ guidelines were used for reporting.

    Results

    Meta-inferenced results of quantitative and qualitative findings show the pandemic was a traumatic experience for healthcare workers. Main theme; When work became a frightening experience in a dehumanized reality, comprised four themes: Entering unprepared into a frightful, incomprehensible world; Sacrificing moral values and harbouring dilemmas in isolation; Lack of clear management; and Reorient in togetherness and find meaning in a changed reality. Qualitative results comprised four categories; Working in a dehumanized world; Living in betrayal of ones' own conscience; Lack of structure in a chaotic time and Regaining vitality together. Subdimensions comprehensibility and meaningfulness were associated significantly with post-traumatic stress disorder in multiple regression analysis. In multiple regression analysis, sense of coherence was the most prominent coping strategy.

    Conclusions

    Forcing oneself to perform beyond one's limit, sacrificing moral values and lacking management was a traumatic experience to healthcare workers during the pandemic. Reorienting as a way of coping was possible in togetherness with colleagues. There is an urgency of interventions to meet the needs among healthcare workers who took on a frontline role during the COVID-19 pandemic and to prevent mental health illness in future crisis.

  • 12.
    Carnesten, Hillewi
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    von Heideken Wågert, Petra
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Wiklund, Lena
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Toivanen, Susanna
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Skoglund, Karin
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Andreae, Christina
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Jaarsma, Tiny
    Struggling with frightening experiences in a transformed reality: A mixed methods study of healthcare workers’ experiences during the pandemic.2023Conference paper (Other academic)
    Abstract [en]

    Background: The COVID-19 pandemic continues to impact health care workers’ (HCWs’) mental health. Research show that psychological distress and hard challenges abide with strong commitment to contribute. Yet, in-depth understanding of HCWs’ experiences of the changed caring reality during the pandemic is missing. Mixed methods research (MMR) accommodates several features apart from employing either quantitative or qualitative methods. This presentation focuses on examples from the 13-step mixed method by Leech and Onwuegbuzie.

    Methods: 97 HCWs in one hard-hit region in Sweden answered a web-based questionnaire measuring symptoms of stress (using DSM-5 criteria for post-traumatic stress syndrome, PTSD) in relation to perceived sense of coherence (SOC-scale) and self-compassion (SCS) as well as HCWs’ experiences. First, qualitative data (experiences of the pandemic) was analyzed by qualitative content analysis, then quantitative data (associations between PTSD and SOC/SCS) were analyzed with linear regression adjusted for covariates. Thirdly, a synthesis, the meta-inference of qualitative and quantitative data, explained a new comprehensive understanding. 

    Results: By analyzing the categories and subcategories from the qualitative analysis in relation to symtoms of stress and SOC/SCS, a synthesis emerged. This was undertaken by merging and comparing the findings and discussing the new comprehensive understanding. Finally, to fully outline the mixed methods approach, qualitative and quantitative data were synthesized into a new comprehensive whole, a meta inference. 

    Conclusion: This study moves away from dichotomic traditions between qualitative or quantitative approaches. By broadening the methodological departure this study may provide a new comprehensive understanding and contribute to enhance quality in MMR. 

  • 13.
    de Oliveira, Thais Lopes
    et al.
    Fundacao Oswaldo Cruz, Natl Sch Publ Hlth, Dept Epidemiol & Quantitat Methods Hlth, Rio De Janeiro, Brazil..
    Carvalhaes de Oliveira, Raquel Vasconcellos
    Fundacao Oswaldo Cruz, Evandro Chagas Natl Inst Infect Dis INI, Clin Epidemiol Lab, Rio De Janeiro, Brazil..
    Griep, Rosane Harter
    Fundacao Oswaldo Cruz, Oswaldo Cruz Inst, Lab Hlth & Environm Educ, Rio De Janeiro, Brazil..
    Moreno, Arlinda B.
    Fundacao Oswaldo Cruz, Natl Sch Publ Hlth, Dept Epidemiol & Quantitat Methods Hlth, Rio De Janeiro, Brazil..
    Prates Melo, Enirtes Caetano
    Fundacao Oswaldo Cruz, Natl Sch Publ Hlth, Dept Epidemiol & Quantitat Methods Hlth, Rio De Janeiro, Brazil..
    Lotufo, Paulo Andrade
    Univ Sao Paulo, Univ Hosp, Ctr Clin & Epidemiol Res, Sao Paulo, Brazil..
    Toivanen, Susanna
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Mendes da Fonseca, Maria de Jesus
    Fundacao Oswaldo Cruz, Natl Sch Publ Hlth, Dept Epidemiol & Quantitat Methods Hlth, Rio De Janeiro, Brazil..
    The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil): Factors Related to Smoking Cessation2022In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558Article in journal (Refereed)
    Abstract [en]

    Background Smoking cessation is not an easy accomplishment. However, the benefits are several for those who do it, such as cardiovascular risk reduction 1 year after quitting smoking. This study aimed to verify the factors related to smoking cessation in civil servants of The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Methods This study had a longitudinal design using data from a prospective cohort of civil servants (ELSA-Brasil). Our variable of interest was smoking cessation. The relationship between socio-demographic characteristics, job stress, health-related variables, legislation, and smoking cessation was analyzed by Cox proportional hazard models. The analyses were stratified by gender. Second-hand smoke exposure, age, education, excessive alcohol consumption, common mental disorder, and smoking control law were the variables considered in the final model. Results Information of 2020 women and 2429 men was analyzed. Individuals without second-hand smoke exposure, with up to 49 years of age, with higher education, without excessive alcohol consumption, without common mental disorders, and who initiated smoking in 1989 or after the smoking control law had a higher risk of stopping smoking. The risks magnitudes were higher for women. Conclusions Our study reinforces the necessity of alcohol consumption regulation, the relevance of Public Health Policies, and the need for more smoking cessation measures focused on men, on people with mental disorders, alcoholism, and older adults. Also, our results did not show significant risks regarding the psychosocial working environment.

  • 14.
    Dellve, Lotta
    et al.
    Göteborgs universitet, Sweden.
    Håkansta, Carin
    Karlstads universitet, Sweden.
    Toivanen, Susanna
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    Kylin, Camilla
    Karlstads universitet, Sweden.
    Lindberg, Per
    Högskolan i Gävle, Sweden.
    Rydenfält, Christofer
    Lunds tekniska högskola, Sweden.
    Ståhl, Christian
    Linköpings universitet, Sweden.
    Berglund, Leif
    Luleå tekniska universitet, Sweden.
    Kaltenbrunner Nykvist, Monica
    Högskolan i Gävle, Sweden.
    Snabbt förändrade arbetsmiljöer kräver forskning som bidrar till bred kunskap och metodik2018In: Arbetsmarknad & Arbetsliv, ISSN 1400-9692, E-ISSN 2002-343X, Vol. 24, no 3-4, p. 85-89Article in journal (Refereed)
  • 15.
    Drake, Emma
    et al.
    Stockholm University, Stockholm, Sweden.
    Toivanen, Susanna
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Stockholm University, Stockholm, Sweden.
    Leineweber, Constanze
    Stockholm University, Stockholm, Sweden.
    Nyberg, Anna
    Stockholm University, Stockholm, Sweden.
    Is combining human service work with family caregiving associated with additional odds of emotional exhaustion and sickness absence? A cross-sectional study based on a Swedish cohort2020In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 93, no 1, p. 55-65Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The aim of the study is to examine to what extent human service work and family caregiving is associated with emotional exhaustion and sickness absence, and to what extent combining human service work and family caregiving is associated with additional odds.

    METHODS: Data were derived from participants in paid work from the Swedish Longitudinal Occupational Survey of Health, year 2016 (n = 11 951). Logistic regression analyses were performed and odds ratios and 95% confidence intervals estimated for the association between human service work and family caregiving, respectively, as well as combinations of the two on one hand, and emotional exhaustion and self-reported sickness absence on the other hand. Interaction between human service work and family caregiving was assessed as departure from additivity with Rothman's synergy index.

    RESULTS: Human service work was not associated with higher odds of emotional exhaustion, but with higher odds of sickness absence. Providing childcare was associated with higher odds of emotional exhaustion, but lower odds of sickness absence, and caring for a relative was associated with higher odds of both emotional exhaustion and sickness absence. There was no indication of an additive interaction between human service work and family caregiving in relation to neither emotional exhaustion nor sickness absence.

    CONCLUSIONS: We did not find support for the common assumption that long hours providing service and care for others by combining human service work with family caregiving can explain the higher risk of sickness absence or emotional exhaustion among employees in human service occupations.

  • 16.
    Dunlavy, A. C.
    et al.
    Stockholm University/Karolinska Institutet.
    Juárez, S.
    Stockholm University/Karolinska Institutet.
    Toivanen, Susanna
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Stockholm University/Karolinska Institutet.
    Rostila, M.
    Stockholm University/Karolinska Institutet.
    Suicide risk among native- and foreign-origin persons in Sweden: a longitudinal examination of the role of unemployment status2019In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 54, no 5, p. 579-590Article in journal (Refereed)
    Abstract [en]

    Purpose: Prior research has documented an association between unemployment and elevated suicide risk. Yet, few Swedish studies have explicitly considered how such risk may vary by different migration background characteristics among persons of foreign-origin, who often experience diverse forms of labor market marginalization. This study examines the extent to which unemployment status may differentially influence suicide risk among the foreign-origin by generational status, region of origin, age at arrival, and duration of residence. Methods: Population-based registers were used to conduct a longitudinal, open cohort study of native-origin and foreign-origin Swedish residents of working age (25–64 years) from 1993 to 2008. Hazard ratios and 95% confidence intervals for suicide mortality were estimated using gender-stratified Cox proportional hazards models. Results: Elevated suicide risk observed among foreign-origin unemployed groups was generally of a similar or lower magnitude than that found in unemployed native-origin, although unemployed second-generation Swedish men demonstrated significantly greater (p < 0.05) excess risk of suicide than that observed among their native-origin counterparts. Unemployed foreign-born men with a younger age at arrival and longer duration of residence demonstrated an increased risk of suicide, while those who arrived as adults, and a shorter duration of residence did not show any increased risk. Among foreign-born women, excess suicide risk persisted regardless of age at arrival and duration of residence in the long-term unemployed. Conclusions: Multiple migration background characteristics should be considered when examining relationships between employment status and suicide among the foreign-origin.

  • 17. Eto, Fabiola Naomi
    et al.
    Santos, RS
    Melo, ECP
    Harter Griep, Rosane
    Toivanen, Susanna
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    958 Comparing two approaches to scoring allostatic load in brazilian civil servants: April 2018 Occupational and Environmental Medicine 75(Suppl 2):A309.1-A3092018In: Occupational and Environmental Medicine, 2018, Vol. 75(Suppl2), p. A309.1-a309.Conference paper (Refereed)
  • 18.
    Fahlén Bergh, Cecilia
    et al.
    Karolinska Institutet,Stockholm, Sweden.
    Toivanen, Susanna
    Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    Johnell, Kristina
    Karolinska Institutet, Stockholm,Sweden.
    Calissendorff, Jan
    Karolinska Institutet, Stockholm,Sweden.
    Skov, Jakob
    Karolinska Institutet, Stockholm,Sweden.
    Falhammar, Henrik
    Karolinska Institutet, Stockholm,Sweden.
    Nathanson, David
    Karolinska Institutet, Stockholm,Sweden.
    Lindh, Jonatan D
    Karolinska Institutet, Stockholm,Sweden.
    Mannheimer, Buster
    Karolinska Institutet, Stockholm,Sweden.
    Factors of importance for discontinuation of thiazides associated with hyponatremia in Sweden: A population-based register study.2019In: Pharmacoepidemiology and Drug Safety, ISSN 1053-8569, E-ISSN 1099-1557Article in journal (Refereed)
    Abstract [en]

    PURPOSE: In a patient with clinically significant hyponatremia without other clear causes, thiazide treatment should be replaced with another drug. Data describing to which extent this is being done are scarce. The aim of this study was to investigate sociodemographic and socioeconomic factors that may be of importance for the withdrawal of thiazide diuretics in patients hospitalized due to hyponatremia.

    METHODS: The study population was sampled from a case-control study investigating individuals hospitalized with a main diagnosis of hyponatremia. For every case, four matched controls were included. In the present study, cases (n = 5204) and controls (n = 7425) that had been dispensed a thiazide diuretic prior to index date were identified and followed onward regarding further dispensations. To investigate the influence of socioeconomic and sociodemographic factors, multiple logistic regression was used.

    RESULTS: The crude prevalence of thiazide withdrawal for cases and controls was 71.9% and 10.8%, respectively. Thiazide diuretics were more often withdrawn in medium-sized towns (adjusted OR, 1.52; 95% CI, 1.21-1.90) and rural areas (aOR, 1.81; 95% CI, 1.40-2.34) compared with metropolitan areas and less so among divorced (aOR, 0.72; 95% CI, 0.53-0.97). However, education, employment status, income, age, country of birth, and gender did not influence withdrawal of thiazides among patients with hyponatremia.

    CONCLUSIONS: Thiazide diuretics were discontinued in almost three out of four patients hospitalized due to hyponatremia. Educational, income, gender, and most other sociodemographic and socioeconomic factors were not associated with withdrawal of thiazides.

  • 19.
    Gisselmann, Marit
    et al.
    Myndigheten för ungdoms- och civilsamhällesfrågor, Sweden.
    Hemström, Örjan
    Statistiska centralbyrån, Sweden.
    Toivanen, Susanna
    Mälardalen University, School of Health, Care and Social Welfare. Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    Kön, genus och skillnader i hälsa2018In: Den orättvisa hälsan - om socioekonomiska skillnader i hälsa och livslängd / [ed] Mikael Rostila & Susanna Toivanen, Stockholm: Liber, 2018, 267, p. 67-85Chapter in book (Refereed)
  • 20.
    Griep, Rosane Harter
    et al.
    Fundação Oswaldo Cruz, Brazil.
    Silva-Costa, Aline
    Universidade Federal do Triangulo Mineiro, Brazil.
    Chor, Dóra
    Fundação Oswaldo Cruz, Brazil.
    Cardoso, Letícia de Oliveira
    Fundação Oswaldo Cruz, Brazil.
    Toivanen, Susanna
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Fonseca, Maria de Jesus Mendes da
    Fundação Oswaldo Cruz, Brazil.
    Rotenberg, Lúcia
    Fundação Oswaldo Cruz, Brazil.
    Gender, work-family conflict, and weight gain: four-year follow-up of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)2022In: Cadernos de Saúde Pública, ISSN 0102-311X, E-ISSN 1678-4464, Vol. 38, no 4, article id EN066321Article in journal (Refereed)
    Abstract [en]

    This study sought to analyze the effect of work-to-family conflict (demands from work that affect one’s family/personal life), family-to-work conflict (demands from family/personal life that affect work), and lack of time for self-care and leisure due to professional and domestic demands on the incidence of weight gain and increase in waist circumference by gender in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Our study included 9,159 ELSA-Brasil participants (4,413 men and 4,746 women) who attended baseline (2008-2010) and the first follow-up visit (2012-2014). Weight gain and increase in waist circumference were defined as an annual increase ≥ 75th percentile, i.e., ≥ 1.21kg/year and ≥ 1.75cm/year, respectively for women; and ≥ 0.96kg/year and ≥ 1.41cm/year respectively for men. Associations were estimated by Poisson regression applying robust variance with the R software. Analyses were stratified by gender and adjusted for socioeconomic variables. Adjusted models showed a higher risk of weight gain among women who reported family-to-work conflict frequently and sometimes (relative risk - RR = 1.37 and RR = 1.15, respectively) and among those who reported frequent lack of time for self-care and leisure (RR = 1.13). Among men, time-based work-to-family conflict (RR = 1.17) and strain-based work-to-family conflict (RR = 1.24) were associated with weight gain. No associations were observed between work-family conflict domains and increase in waist circumference. These findings suggest that occupational and social health promotion programs are essential to help workers balance work and family life to reduce weight gain.

  • 21.
    Griep, Rosane Härter
    et al.
    Laboratory of Health and Environment Education, Oswaldo Cruz Institute, Rio de Janeiro, Brazil.
    Bastos, Leonardo S
    Scientific Computing Program (PROCC), Fiocruz, Rio de Janeiro, Brazil.
    Fonseca, Maria de Jesus Mendes da
    National School of Public Health, Fiocruz, Rio de Janeiro, Brazil.
    Silva-Costa, Aline
    National School of Public Health, Fiocruz, Rio de Janeiro, Brazil.
    Portela, Luciana Fernandes
    Laboratory of Health and Environment Education, Oswaldo Cruz Institute, Manguinhos, Rio de Janeiro, Brazil.
    Toivanen, Susanna
    Mälardalen University, School of Health, Care and Social Welfare. Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    Rotenberg, Lucia
    Laboratory of Health and Environment Education, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (Fiocruz), Brazil.
    Years worked at night and body mass index among registered nurses from eighteen public hospitals in Rio de Janeiro, Brazil2014In: BMC Health Services Research, E-ISSN 1472-6963, Vol. 14, article id 603Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Employees working night shifts are at a greater risk of being overweight or obese. Few studies on obesity and weight gain analyze the years of exposure to night work. The aim of this study was to determine the relationship between the years of exposure to night work and body mass index (BMI) among registered nurses.

    METHODS: A cross-sectional analysis was performed in 18 largest public hospitals in Rio de Janeiro, Brazil. A total of 2,372 registered nurses (2,100 women) completed a comprehensive questionnaire concerning sociodemographic, professional, lifestyle, and health behavioral data. Current and past exposures to night shifts as well as BMI values were measured as continuous variables. A gamma regression model was used with an identity link function to establish the association.

    RESULTS: The association between years of exposure to night work and BMI was statistically significant for both women and men after adjusting for all covariates [β = 0.036; CI95% = 0.009-0.063) and β = 0.071 (CI95% = 0.012-0.129), respectively]. The effect of night work was greater among men than women. For example, for those women who have worked at night for 20 years the estimated average BMI was 25.6 kg/m2 [range, 25.0-26.2]. In relation to men, after 20 years of exposure to night work the estimated average BMI was 26.9 kg/m2 [range, 25.6-28.1].

    CONCLUSIONS: These findings suggest that night shift exposure is related to BMI increases. Obesity prevention strategies should incorporate improvements in work environments, such as the provision of proper meals to night workers, in addition to educational programs on the health effects of night work.

  • 22.
    Griep, Rosane Härter
    et al.
    Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Brazil.
    Nobre, Aline Araújo
    Fundação Oswaldo Cruz, Rio de Janeiro RJ, Brazil.
    Alves, Márcia Guimarães de Mello
    Universidade Federal Fluminense, Niterói RJ, Brazil.
    da Fonseca, Maria de Jesus Mendes
    Universidade Federal Fluminense, Niterói RJ, Brazil.
    Cardoso, Letícia de Oliveira
    Universidade Federal Fluminense, Niterói RJ, Brazil.
    Giatti, Luana
    Universidade Federal de Ouro Preto, Belo Horizonte MG, Brazil.
    Melo, Enirtes Caetano Prates
    Fundação Oswaldo Cruz, Rio de Janeiro RJ, Brazil.
    Toivanen, Susanna
    Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    Chor, Dóra
    Fundação Oswaldo Cruz, Rio de Janeiro RJ, Brazil.
    Job strain and unhealthy lifestyle: results from the baseline cohort study, Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).2015In: BMC Public Health, E-ISSN 1471-2458, Vol. 15, article id 309Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Unhealthy lifestyle choices, such as smoking and sedentary behavior, are among the main modifiable risk factors for chronic non-communicable diseases. The workplace is regarded as an important site of potential health risks where preventive strategies can be effective. We investigated independent associations among psychosocial job strain, leisure-time physical inactivity, and smoking in public servants in the largest Brazilian adult cohort.

    METHODS: We conducted a cross-sectional analysis of baseline data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)-a multicenter prospective cohort study of civil servants. Our analytical samples comprised 11,779 and 11,963 current workers for, respectively, analyses of job strain and leisure-time physical activity and analyses of job strain and smoking. Job strain was assessed using the Brazilian version of the Swedish Demand-Control-Support Questionnaire; physical activity was evaluated using a short form of the International Physical Activity Questionnaire. We also examined smoking status and number of cigarettes smoked per day. The association reported in this paper was assessed by means of multinomial and logistic regression, stratified by sex.

    RESULTS: Among men, compared with low-strain activities (low demand and high control), job strain showed an association with physical inactivity (odds ratio [OR] = 1.34; 95% confidence interval [CI] = 1.09-1.64) or with the practice of physical activities of less than recommended duration (OR = 1.44; 95% CI = 1.15-1.82). Among women, greater likelihood of physical inactivity was identified among job-strain and passive-job groups (OR = 1.47; 95% CI = 1.22-1.77 and OR = 1.42; 95% CI = 1.20-1.67, respectively). Greater control at work was a protective factor for physical inactivity among both men and women. Social support at work was a protective factor for physical inactivity among women, as was smoking for both genders. We observed no association between demand or control dimensions and smoking.

    CONCLUSIONS: Job strain, job control, and social support were associated with physical activity. Social support at work was protective of smoking. Our results are comparable to those found in more developed countries; they provide additional evidence of an association between an adverse psychosocial work environment and health-related behaviors.

  • 23.
    Griep, Rosane Härter
    et al.
    Fundacao Oswaldo Cruz, Brazil.
    Toivanen, Susanna
    Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    Santos, Itamar S
    Universidade de Sao Paulo, Brazil.
    Rotenberg, Lucia
    Fundacao Oswaldo Cruz, Brazil.
    Juvanhol, Leidjaira Lopes
    Fundacao Oswaldo Cruz, Brazil.
    Goulart, Alessandra C
    Universidade de Sao Paulo, Brazil.
    Aquino, Estela M
    Universidade Federal da Bahia, Brazil.
    Benseñor, Isabela
    Universidade de Sao Paulo, Brazil.
    Work-family conflict, lack of time for personal care and leisure, and job strain in migraine: Results of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).2016In: American Journal of Industrial Medicine, ISSN 0271-3586, E-ISSN 1097-0274, Vol. 59, no 11, p. 987-1000Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Work-family conflict and time scarcity may affect health. We investigated the association between these issues and migraine, taking into account job strain.

    METHODS: Baseline data from ELSA-Brasil (6,183 women; 5,664 men) included four indicators of work-family conflict: time- and strain-based interference of work with family (TB-WFC, SB-WFC), interference of family with work (FWC) and lack of time for personal care and leisure (LOT). Migraine was classified according to International Headache Society criteria.

    RESULTS: Among women, definite migraine was associated with SB-WFC (odds ratio [OR] = 1.28; 95% confidence interval [CI] 1.06-1.55), FWC (OR = 1.32; 1.00-1.75), and LOT (OR = 1.30; 1.08-1.58). Probable migraine was associated with SB-WFC (OR = 1.17; 1.00-1.36). High psychological job demands and low social support interacted with LOT in association with definite migraine. Among men, probable migraine was associated with LOT (OR = 1.34; 1.09-1.64), and there were interactions between job strain and WFC for probable migraine.

    CONCLUSIONS: Balancing the demands of professional and domestic spheres could be highly relevant in the management of migraines. Am. J. Ind. Med. 59:987-1000, 2016. © 2016 Wiley Periodicals, Inc.

  • 24.
    Griep, Rosane Härter
    et al.
    Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Brazil.
    Toivanen, Susanna
    Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    van Diepen, Cornelia
    Portsmouth University, Portsmouth, UK.
    Guimarães, Joanna M N
    Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Brazil.
    Camelo, Lidyane V
    Faculty of Medicine, Universidade Federal de Minas Gerais, Minas Gerais, Brazil.
    Juvanhol, Leidjaira Lopes
    Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Brazil.
    Aquino, Estela M
    Federal University of Bahia, Salvador, Bahia, Brazil.
    Chor, Dóra
    Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Brazil.
    Work-Family Conflict and Self-Rated Health: the Role of Gender and Educational Level. Baseline Data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).2016In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 23, no 3, p. 372-382Article in journal (Refereed)
    Abstract [en]

    PURPOSE: This study examined gender differences in the association between work-family conflict and self-rated health and evaluated the effect of educational attainment.

    METHOD: We used baseline data from ELSA-Brasil, a cohort study of civil servants from six Brazilian state capitals. Our samples included 12,017 active workers aged 34-72 years. Work-family conflict was measured by four indicators measuring effects of work on family, effects of family in work and lack of time for leisure and personal care.

    RESULTS: Women experienced more frequent work-family conflict, but in both genders, increased work-family conflict directly correlated with poorer self-rated health. Women's educational level interacted with three work-family conflict indicators. For time-based effects of work on family, highly educated women had higher odds of suboptimal self-rated health (OR = 1.54; 95 % CI = 1.19-1.99) than less educated women (OR = 1.14; 95 % CI = 0.92-1.42). For strain-based effects of work on family, women with higher and lower education levels had OR = 1.91 (95 % CI 1.48-2.47) and OR = 1.40 (95 % CI 1.12-1.75), respectively. For lack of time for leisure and personal care, women with higher and lower education levels had OR = 2.60 (95 % CI = 1.95-3.47) and OR = 1.11 (95 % CI = 0.90-1.38), respectively.

    CONCLUSION: Women's education level affects the relationship between work-family conflict and self-rated health. The results may contribute to prevention activities.

  • 25.
    Hagqvist, E.
    et al.
    Stockholm University, Sweden.
    Vinberg, S.
    Mid Sweden University, Sweden.
    Toivanen, Susanna
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Stockholm University, Sweden.
    Hagström, M.
    Mid Sweden University, Sweden.
    Granqvist, S.
    Mid Sweden University, Sweden.
    Landstad, B. J.
    Mid Sweden University, Sweden.
    Falling outside the system: Occupational safety and health inspectors’ experiences of micro-enterprises in Sweden2020In: Safety Science, ISSN 0925-7535, E-ISSN 1879-1042, Vol. 125, article id 104631Article in journal (Refereed)
    Abstract [en]

    In this study, 11 Swedish occupational safety and health (OSH) inspectors were interviewed about their views of and experiences interacting with micro-enterprises (1-9 employees). The qualitative content analysis found one theme, “Falling outside the system”, and three subthemes, “The inspector—shaped by specific standards”, “The bureaucrat and the micro-entrepreneur—two separate worlds”, and “System faults and system changes”. According to the inspectors, the Swedish OSH regulatory system, with inspectors on the front line, neglects the specific needs, circumstances and characteristics of micro-enterprises. Therefore, we suggest revising the OSH regulatory system and following inspection methods and enforcement styles to better address the needs of micro-enterprises.

  • 26. Hagqvist, Emma
    et al.
    Bernhard-oettel, Claudia
    Toivanen, Susanna
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    Balancing work and life when self-employed: the role of gender contexts2018In: Gender perspectives on self-employment focusing on work - life balance and working conditions, 2018Conference paper (Refereed)
  • 27.
    Hagqvist, Emma
    et al.
    Mid Sweden University, Östersund, Sweden.
    Toivanen, Susanna
    Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    Bernhard-Oettel, Claudia
    Stockholm University, 106 91 Stockholm, Sweden.
    Balancing Work and Life When Self-Employed: The Role of Business Characteristics, Time Demands, and Gender Contexts2018In: Social Sciences, E-ISSN 2076-0760, Vol. 7, no 8, p. 139-Article in journal (Refereed)
    Abstract [en]

    This study explores individual and contextual risk factors in relation to work interfering with private life (WIL) and private life interfering with work (LIW) among self-employed men and women across European countries. It also studies the relationship between interference (LIW and WIL) and well-being among self-employed men and women. Drawing on data from the fifth round of the European Working Conditions Survey, a sample of self-employed men and women with active businesses was extracted. After applying multilevel regressions, results show that although business characteristics are important, the most evident risk factor for WIL and LIW is time demands. Both time demands and business characteristics also seem to be important factors in relation to gender differences in level of interference. There is a relationship between well-being and both WIL and LIW, and time demands is again an important factor. Gender equality in the labor market did not relate to level of interference, nor did it affect the relationship between interference and well-being. However, in gender-separated analyses, LIW and LIW interacted with gender equality in the labor market in different ways for women’s and men’s well-being. In conclusion, gender relations are important in interference and how interference relates to well-being

  • 28.
    Hagqvist, Emma
    et al.
    Mid Sweden University, Östersund, Sweden.
    Toivanen, Susanna
    Stockholm University, Stockholm, Sweden.
    Vinberg, Stig
    Mid Sweden University, Östersund, Sweden.
    The gender time gap: Time use among self-employed women and men compared to paid employees in Sweden2019In: Time & Society, ISSN 0961-463X, E-ISSN 1461-7463, Vol. 28, no 2, p. 680-696Article in journal (Refereed)
    Abstract [en]

    In this article, the authors set out to study the time use of men and women in Sweden, comparing self-employed and employed individuals. Previous studies indicate that there are reasons to believe that both gendered time use and mechanisms related to time use might differ between the self-employed and employees. Employing time use data, the aim was to study whether there are differences in gendered time use between self-employed individuals and employees in Sweden, and furthermore, which mechanism relates to gendered time use among self-employed individuals and employees. The results show that self-employed men and women distribute their time in a more gender-traditional manner than employees. In addition, relative resources are found to be an important factor related to gendered time use among the self-employed. For employees, gender relations tend to be a mechanism related to …

  • 29.
    Hagqvist, Emma
    et al.
    Stockholm Univ, Stress Res Inst, Dept Psychol, Stockholm, Sweden.;Mid Sweden Univ, Dept Hlth Sci, Ostersund, Sweden..
    Vinberg, Stig
    Mid Sweden Univ, Dept Hlth Sci, Ostersund, Sweden..
    Toivanen, Susanna
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Stockholm Univ, Dept Publ Hlth Sci, Stockholm, Sweden.;Malardalen Univ, Sch Hlth Care & Social Welf, Vasterls, Sweden..
    Landstad, Bodil J.
    Mid Sweden Univ, Dept Hlth Sci, Ostersund, Sweden.;Nord Trondelag Hosp Trust, Levanger Hosp, Levanger, Norway..
    A balancing act: Swedish occupational safety and health inspectors' reflections on their bureaucratic role when supervising micro-enterprises2021In: Small Business Economics, ISSN 0921-898X, E-ISSN 1573-0913, Vol. 57, no 2, p. 821-834Article in journal (Refereed)
    Abstract [en]

    The safety and health of many workers employed in micro-enterprises (with less than 10 employees) is poor, and legal arrangements related to working environments remain a considerable challenge in these enterprises. The aim of this study is to gain a deeper understanding of how Swedish occupational safety and health (OSH) inspectors perceive themselves as inspectors and their role as bureaucratic regulators when meeting micro-enterprises. In the study, 11 Swedish inspectors were interviewed and asked to reflect on their role as inspectors, how they perceive themselves as inspectors and what their role is as bureaucratic regulators when inspecting micro-enterprises. The qualitative content analysis revealed one theme-a balancing act-and three categories: one inspector, many roles; interactions with micro-entrepreneurs; and exercise the profession as an inspector. The results showed that OSH inspectors experience challenges in meeting the requirements of street-level bureaucracy while addressing the needs of micro-enterprises. In conclusion, OSH inspectors need organisational support to develop inspection models and enforcement styles tailored to micro-enterprises, as this could ease their work and contribute to better inspection outcomes. The implications of this study include a need for increased competence about working environment issues in micro-enterprises, development of enforcement styles among the inspectors, emphasis of the importance of specific governmental projects for OSH and development of models in this enterprise group. Additionally, development of micro-enterprise managers' competence and ability to handle issues related to the working environment and health were also important.

  • 30.
    Halling Ullberg, Oskar
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Toivanen, Susanna
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Department of Public Health Sciences, Stockholm University, Stockholm, Sweden.
    Tillander, A.
    Department of Statistics and Machine Learning, Linköping University, Linköping, Sweden.
    Bälter, Katarina
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden.
    Workplace health promotion to facilitate physical activity among office workers in Sweden2023In: Frontiers In Public Health, ISSN 2296-2565, Vol. 11, article id 1175977Article in journal (Refereed)
    Abstract [en]

    Office workers spend most of their working time being sedentary, contributing to a sedentary lifestyle that increases the risk of developing disease and disability. A gradual decline in cardiorespiratory fitness among adults, along with increased rate of non-communicable diseases across developed countries, makes the workplace an important opportunity for promoting healthy behaviors. This study aimed to investigate: how office companies in Sweden organize and provide workplace health promotion services related to physical activity; the companies' vision for providing workplace health promotion; and potential facilitators and barriers. Nine informants from eight companies participated in the study, and both qualitative and quantitative data were collected by semi-structured interviews. Informants were selected through purposive sampling in collaboration with eight companies in the office market, including companies that own and develop office buildings, shared workspaces, interior design, sustainable solutions, or consult on issues related to the office sector. The framework method was used to analyze the data in a flexible and systematic way. The results showed that workplace health promotion is implemented to maintain employee health, productivity, and employee branding. Also, a significant number of financial resources, organizational support and office space are devoted to workplace health promotion. Convenience and easy access to storage and fitness facilities are key facilitators. In conclusion, this study highlights the importance of employees' engagement in developing and improving workplace health promotion and addressing work-life balance constraints that hinder a healthy lifestyle. Removing barriers on an organizational level may improve the usage of workplace health promotion related to physical activity among office employees. Copyright © 2023 Halling Ullberg, Toivanen, Tillander and Bälter.

  • 31.
    Hökerberg, Yara Hahr Marques
    et al.
    Laboratório de Epidemiologia Clínica, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil..
    Reichenheim, Michael Eduardo
    Departamento de Epidemiologia, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil..
    Faerstein, Eduardo
    Departamento de Epidemiologia, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil..
    Passos, Sonia Regina Lambert
    Laboratório de Epidemiologia Clínica, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil..
    Fritzell, Johan
    Karolinska Institute.
    Toivanen, Susanna
    Mälardalen University, School of Health, Care and Social Welfare. Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    Westerlund, Hugo
    Stockholm University.
    Cross-cultural validity of the demand-control questionnaire: Swedish and Brazilian workers.2014In: Revista de Saude Publica, ISSN 0034-8910, E-ISSN 1518-8787, Vol. 48, no 3, p. 486-96, article id S0034-89102014000300486Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE To evaluate the cross-cultural validity of the Demand-Control Questionnaire, comparing the original Swedish questionnaire with the Brazilian version. METHODS We compared data from 362 Swedish and 399 Brazilian health workers. Confirmatory and exploratory factor analyses were performed to test structural validity, using the robust weighted least squares mean and variance-adjusted (WLSMV) estimator. Construct validity, using hypotheses testing, was evaluated through the inspection of the mean score distribution of the scale dimensions according to sociodemographic and social support at work variables. RESULTS The confirmatory and exploratory factor analyses supported the instrument in three dimensions (for Swedish and Brazilians): psychological demands, skill discretion and decision authority. The best-fit model was achieved by including an error correlation between work fast and work intensely (psychological demands) and removing the item repetitive work (skill discretion). Hypotheses testing showed that workers with university degree had higher scores on skill discretion and decision authority and those with high levels of Social Support at Work had lower scores on psychological demands and higher scores on decision authority. CONCLUSIONS The results supported the equivalent dimensional structures across the two culturally different work contexts. Skill discretion and decision authority formed two distinct dimensions and the item repetitive work should be removed.

  • 32.
    Javan Abraham, Feben
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Andreasson, P.
    Mälardalen University.
    King, A.
    Stanford Univ, Epidemiol & Populat Hlth, Palo Alto, CA 94304 USA..
    Bälter, Katarina
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden.
    Toivanen, Susanna
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Introducing outdoor office work to reduce stress among office workers in Sweden2023In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 33Article in journal (Other academic)
  • 33.
    Juvanhol, Leidjaira Lopes
    et al.
    Department of Nutrition and Health, Federal University of Viçosa (UFV), Viçosa, MG, Brazil.
    Silva-Costa, Aline
    Federal University of Triangulo Mineiro (UFTM), Uberaba, MG, Brazil.
    Rotenberg, Lucia
    Laboratory of Health and Environment Education, Oswaldo Cruz Institute, Rio de Janeiro, Brazil.
    Moreno, Arlinda B.
    National School of Public Health, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, RJ, Brazil.
    Melo, Enirtes Caetano Prates
    National School of Public Health, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, RJ, Brazil.
    Santos, Itamar S.
    University of São Paulo (USP), São Paulo, SP, Brazil.
    Nunes, Maria Angélica Antunes
    Federal University of Rio Grande do Sul (UFRGS), Rio Grande do Sul, Brazil.
    Toivanen, Susanna
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Chor, Dóra
    National School of Public Health, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, RJ, Brazil.
    Griep, Rosane Härter
    Laboratory of Health and Environment Education, Oswaldo Cruz Institute, Rio de Janeiro, Brazil.
    Is work-family conflict a pathway between job strain components and binge eating? A cross-sectional analysis from the ELSA-Brasil study2022In: Journal of Eating Disorders, E-ISSN 2050-2974, Vol. 10, no 1, article id 16Article in journal (Refereed)
    Abstract [en]

    Background

    Job strain has been reported as a trigger for binge eating, yet the underlying mechanisms have been unclear. The aim of this study was to evaluate whether work-family conflict is a pathway in the association between job strain and binge eating, considering the possible effect-modifying influence of body mass index (BMI).

    Methods

    This cross-sectional analysis included 12,084 active civil servants from the multicenter Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Job strain was assessed using the Demand-Control-Support Questionnaire. Work-family conflict was considered as a latent variable comprising three items. Binge eating was defined as eating a large amount of food in less than 2 h at least twice a week in the last six months with a sense of lack of control over what and how much was eaten. Structural equation modelling was used to test the role of work-family conflict in the association between job strain and binge eating, stratifying for BMI.

    Results

    For individuals of normal weight, positive associations were found between skill discretion and binge eating (standardized coefficient [SC] = 0.209, 95%CI = 0.022–0.396), and between psychological job demands and work-family conflict (SC = 0.571, 95%CI = 0.520–0.622), but no statistically significant indirect effect was found. In overweight individuals, psychological job demands, skill discretion, and work-family conflict were positively associated with binge eating (SC = 0.099, 95%CI = 0.005–0.193; SC = 0.175, 95%CI = 0.062–0.288; and SC = 0.141, 95%CI = 0.077–0.206, respectively). Also, work-family conflict was observed to be a pathway on the associations of psychological job demands and decision authority with binge eating (SC = 0.084, 95%CI = 0.045–0.122; and SC =  − 0.008, 95%CI =  − 0.015– − 0.001, respectively).

    Conclusions

    Work-family conflict partly explains effects of high levels of psychological job demands and low levels of decision authority on binge eating among overweight individuals. Moreover, skill discretion is positively associated with binge eating, regardless of BMI category.

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  • 34.
    Klingelschmidt, Justine
    et al.
    Inserm, U1085, Équipe ESTER, Angers, France.
    Milner, Allison
    University of Melbourne, Melbourne, Australie.
    Khireddine-Medouni, Imane
    Santé publique France, Direction Santé Travail, Saint-Maurice, France.
    Witt, Katrina
    Monash University, Fitzroy, Australia.
    Alexopoulos, Evangelos C
    IASO General Hospital, Athens, Greece.
    Toivanen, Susanna
    Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    LaMontagne, Anthony D
    Stockholm University, Stockholm, Suede.
    Chastang, Jean-François
    Université d’Angers, Équipe ESTER, Angers, France.
    Niedhammer, Isabelle
    Université d’Angers, Équipe ESTER, Angers, France.
    Le suicide chez les travailleurs du secteur agriculture, sylviculture et pêche: une revue systématique de la littérature et méta-analyse2019In: Archives des maladies professionnelles et de l'environnement, ISSN 1775-8785, E-ISSN 1778-4190, Vol. 79, no 4, p. 561-562Article in journal (Refereed)
    Abstract [fr]

    ObjectifsLes objectifs de l’étude étaient de quantifier le risque de suicide des travailleurs de l’agriculture, de la sylviculture et de la pêche via une revue systématique de la littérature et une méta-analyse et d’étudier les éventuelles variations de risque au sein de cette population selon ses caractéristiques professionnelles et sociodémographiques. Jusqu’à présent, le suicide au sein de cette population n’avait jamais fait l’objet d’une revue systématique de la littérature et/ou d’une méta-analyse.MéthodesUne revue systématique de la littérature sur la période 1995–2016 et une méta-analyse à partir de la base de données MEDLINE via le moteur de recherche Pubmed ont été réalisées conformément aux recommandations PRISMA. La méta-analyse a permis de calculer une estimation poolée de la taille d’effet du risque de suicide au sein de la population d’intérêt. Des analyses par sous-groupes ont ensuite été …

  • 35.
    Klingelschmidt, Justine
    et al.
    Research Institute for Environmental and Occupational Health (IRSET), Epidemiology in Occupational Health and Ergonomics (ESTER) Team, Angers, France..
    Milner, Allison
    University of Melbourne, Melbourne School of Population and Global Health, Centre for Health Equity, Melbourne, Australia..
    Khireddine-Medouni, Imane
    Santé Publique France, Direction Santé Travail, Saint-Maurice, France.
    Witt, Katrina
    Monash University, Turning Point, Eastern Health Clinical School, Fitzroy, Australia.
    Alexopoulos, Evangelos C
    Occupational Health Unit, “IASO” General Hospital, Athens, Greece.
    Toivanen, Susanna
    Stockholm University, Centre for Health Equity Studies, Stockholm, Sweden.
    LaMontagne, Anthony D
    Deakin University, Centre for Population Health Research, School of Health & Social Development, Geelong, Australia.
    Chastang, Jean-François
    Research Institute for Environmental and Occupational Health (IRSET), Epidemiology in Occupational Health and Ergonomics (ESTER) Team, Angers, France.
    Niedhammer, Isabelle
    Research Institute for Environmental and Occupational Health (IRSET), Epidemiology in Occupational Health and Ergonomics (ESTER) Team, Angers, France..
    Suicide among agricultural, forestry, and fishery workers: A systematic literature review and meta-analysis.2018In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 44, no 1, p. 3-15, article id 3682Article, review/survey (Refereed)
    Abstract [en]

    Objectives This review aimed to quantify suicide risk among agricultural, forestry, and fishery workers and study potential variations of risk within this population. Methods We conducted a systematic literature review and meta-analysis from 1995 to 2016 using MEDLINE and following the PRISMA guidelines. A pooled effect size of suicide risk among the population of interest was calculated using meta-analysis. Subgroup analyses were conducted to investigate whether effect size differed according to population or study characteristics. Meta-regression was used to identify sources of heterogeneity. Results The systematic review identified 65 studies, of which 32 were included in the meta-analysis. Pooled effect size was 1.48 [95% confidence interval (CI) 1.30-1.68] representing an excess of suicide risk among the population of interest. Subgroup analysis showed that this effect size varied according to geographic area, with a higher effect size in Japan. The following study characteristics were found to contribute to the between-study variance: reference group, measure of effect size, and study design. Conclusions Our findings suggest an excess of suicide risk among agricultural, forestry, and fishery workers and demonstrated that this excess may be even higher for these groups in Japan. This review highlights the need for suicide prevention policies focusing on this specific population of workers. More research is also needed to better understand the underlying factors that may increase suicide risk in this population.

  • 36.
    Lundeberg, Olle
    et al.
    Stockholm University, Stockholm, Sweden.
    Toivanen, Susanna
    Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    Sense of Coherence and Social Structure2019In: Encyclopedia of Environmental Health, vol 5, Edition: 2nd, Saunders Elsevier, 2019, p. 704-709Chapter in book (Refereed)
    Abstract [en]

    In the international literature on the importance of social and psychosocial factors for health, a number of concepts focused on people’s relation to their environment are put forward, albeit in different forms. A common theme is whether people’s cognition of and reaction to their environment may influence their health, and even promote health or buffer stress. Of these concepts, the notion of sense of coherence (SOC) developed by medical sociologist Aaron Antonovsky has gained much attention. According to Antonovsky’s salutogenic model, people who perceive their life as comprehensible and meaningful and who also consider themselves capable of managing problems are better able to deal successfully with health-threatening stressful situations of everyday life. Salutogenesis, the origin of health, focuses on the interaction between people and the structures of society, and elucidates how people manage stress and stay well despite stressful situations and hardships.

  • 37.
    Manhica, Hélio
    et al.
    Stockholm University.
    Toivanen, Susanna
    Mälardalen University, School of Health, Care and Social Welfare. Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    Hjern, Anders
    Stockholm University.
    Rostila, Mikael
    Stockholm University.
    Mortality in adult offspring of immigrants: a Swedish national cohort study.2015In: PLOS ONE, E-ISSN 1932-6203, Vol. 10, no 2, article id e0116999Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Higher risks of psychiatric disorders and lower-than-average subjective health in adulthood have been demonstrated in offspring of immigrants in Sweden compared with offspring of native Swedes, and linked to relative socioeconomic disadvantage. The present study investigated mortality rates in relation to this inequity from a gender perspective.

    METHODS: We used data from national registers covering the entire Swedish population aged 18-65 years. Offspring of foreign-born parents who were either Swedish born or had received residency in Sweden before school age (<7 years) were defined as "offspring of immigrants." We used Cox regression models to examine the association between parental country of birth and mortality between 1990 and 2008, with adjustment for education, income, age and family type.

    RESULTS: Male offspring of immigrants from the Middle East (HR:2.00, CI:1.66-2.26), other non-European countries (HR:1.80, CI:1.36-2.36) and Finland (HR:1.56, CI:1.48-1.65) showed an age-adjusted excess mortality risk from all causes of death when compared to offspring with Swedish-born parents. Income, but not education, greatly attenuated these increased mortality risks. No excess mortality rates were found among female offspring of immigrants, with the exception of external cause of death among offspring of Finnish immigrants.

    CONCLUSION: The study demonstrates high mortality rates in male offspring of immigrants from Finland and non-European countries that are associated with economic, but not educational, disadvantage. No increased mortality rates were found among female offspring of immigrants. Future studies are needed to explain this gender differential and why income, but not education, predicts mortality in male offspring of immigrants.

  • 38.
    Mellner, Christin
    et al.
    Department of Psychology, Stockholm University, Stockholm, Sweden.
    Peters, Pascale
    Strategic Human Resource Management, Nyenrode Business University, Utrecht, Netherlands.
    Dragt, Maria Johanna
    Strategic Human Resource Management, Nyenrode Business University, Utrecht, Netherlands.
    Toivanen, Susanna
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Predicting Work-Life Conflict: Types and Levels of Enacted and Preferred Work-Nonwork Boundary (In)Congruence and Perceived Boundary Control2021In: Frontiers in Psychology, E-ISSN 1664-1078, Vol. 12, article id 772537Article in journal (Refereed)
    Abstract [en]

    In 2020, everyday life changed dramatically for employees worldwide as a result of the outbreak of the Covid-19 pandemic, where an estimated 558 million employees started working from home. The pandemic, therefore, marks a fundamental shift of individuals’ work-nonwork boundaries, which can impact work-life conflict. In particular, the interplay between individuals’ enacted boundaries (degree to which they separate/segment or blend/integrate work-nonwork), preferred boundaries (degree of preferred segmentation or integration of work-nonwork), and perceived control over work-nonwork boundaries, may relate to work-life conflict. This study, the first to the best of our knowledge, examines whether different types and levels of work-nonwork boundary (in)congruence matter for work-life conflict, and whether perceived boundary control moderates these relationships. Boundary (in)congruence represents the degree of (mis)fit between enacted and preferred segmentation or integration. Several types of (in)congruence are distinguished: “segmentation congruence” (enacting and preferring segmentation); “integration congruence” (enacting and preferring integration); “intrusion” (enacting integration but preferring segmentation) and “distance” (enacting segmentation but preferring integration). Data from 1,229 managers working in public and private organizations in Sweden was analyzed using polynomial regression analysis with response surface modeling and moderation analysis in SPSS Process. Findings showed that “integration congruence” was related with higher work-life conflict than “segmentation congruence.” Moreover, a U-shaped relationship between incongruence and work-life conflict was found: the more incongruence, the more work-life conflict. Specifically, “intrusion” was related to higher work-life conflict than “distance.” Finally, boundary control mitigated the effect of incongruence (especially “intrusion”) on work-life conflict. From our findings, we may conclude that work-life conflict is impacted differently depending on the type and level of boundary (in)congruence. Particularly enacted and/or preferred integration may be problematic when it comes to work-life conflict, rather than just (in)congruence per se. Moreover, boundary control can be viewed as a key factor in combating work-life conflict, especially among individuals who enact integration, but prefer segmentation. Taken together, our study contributes new and substantial knowledge by showing the importance for research and HRM-policies that take into account different types and levels of boundary (in)congruence, as these are associated with different levels of work-life conflict, which, in turn, are moderated by boundary control.

  • 39. Mellner, Christin
    et al.
    Peters, Pascale
    Toivanen, Susanna
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    Individual Perceptions of Boundary Control Mitigate the Effect of (in) Congruence Between Workers’ Preferred Work/Non-Work Boundaries and their Enacted Boundary Management on Work-Life Conflict2019In: Abstract Book of the 19th European Association of Work and Organizational Psychology, 2019, p. 693-694Conference paper (Refereed)
    Abstract [en]

    Purpose: Rapid development of boundary-transcending ICTs have led to more flexible forms of work organization, marking a fundamental shift in the flexibility and permeability of employees’ work-nonwork boundaries. This study investigates the inter-relationships between employees’ boundary management types, representing boundary (in)congruence between their preferred and enacted boundary management, and work-life conflict, and the potential moderating role of perceived boundary control herein.

    Design/Methodology: Data comprised 3,154 Swedish professional workers in different occupations within both the public and private sector. Correlations, t-tests, Chi square tests and univariate general linear model analyses (ANCOVA) were performed.

    Findings: Enacted integration as well as boundary incongruence were both positively associated with work-life-conflict. Moreover, incongruence accompanied by a high degree of enacted integration increased work-life conflict. Finally, boundary control mitigated work-life conflict. This was especially the case among employees preferring segmentation but enacting integration, i.e., boundary incongruence, but also among employees both preferring and enacting integration, i.e., boundary congruence.

    Practical implications: This study provides new and valuable knowledge on different boundary management types, reflecting boundary (in)congruence, that are associated with increased work-life conflict depending on the specific type of (in)congruence in question, and the role of boundary control herein as an important factor to combat work-life conflict. This kind of knowledge is of high relevance in contemporary working life characterized by an ever-increased blurring of work-nonwork boundaries. Organizations play an important role in creating new legitimate beliefs and as such, leisure norms could be implemented that promote employees’ boundary control, and subsequent reduced work-life conflict.

  • 40.
    Mensah, Aziz
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Bielefeld University, Bielefeld, Germany.
    Toivanen, Susanna
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. HAL Hållbart arbetsliv.
    Diewald, Martin
    Bielefeld University, Bielefeld, Germany.
    Working Hours, Sleep Disturbance and Self-Assessed Health in Men and Women: A Multilevel Analysis of 30 Countries in Europe2022In: Frontiers in Public Health, E-ISSN 2296-2565, Vol. 10, article id 818359Article in journal (Refereed)
    Abstract [en]

    Objectives: This study examined the gender and cross-country differences in the relationship between working hours and self-assessed health among working men and women in Europe, and further explored the moderating role of sleep disturbance in the relationship.

    Methods: We used cross-sectional data from the 6th European Working Condition Survey on 14,603 men and 15,486 women across 30 countries in Europe. A multivariate logistic regression was applied to evaluate the relationship between working hours, sleep disturbance, and self- assessed health. In addition, we employed a two-stage multilevel logistic regression to assess the cross-country variations in the relationship between working hours and self-assessed health.

    Results: The study showed a slightly U-shaped relationship between working hours and less-than-good self-assessed health among working adults in Europe (<31 h: aOR = 1.11; 95% CI: 1.00–1.25, 41–50 h: aOR = 0.98; 95% CI: 0.84–1.15, and 50+ h: aOR = 1.31; 95% CI: 1.07–1.59). However, working men had higher odds of reporting less-than-good self-assessed health as compared to women when they devote longer hours to paid work. The results further showed that there are cross-country variations in the association between working hours and less-than-good self-assessed health for both men and women, and that men had slightly lower variations as compared to women. Contrary to expectation, sleep disturbance did not moderate the relationship between working hours and less-than-good self-assessed health for both men and women in Europe.

    Conclusions: Although there are gender differences and cross-country variations in the association between working hours and less-than-good self-assessed health, sleep disturbance did not moderate the associations. These findings underscore the importance for strict work time regulation and generous work-family policies that may promote good working conditions and health.

  • 41.
    Mensah, Aziz
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Bielefeld Graduate School in History and Sociology (BGHS), Bielefeld University, Germany.
    Toivanen, Susanna
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Diewald, Martin
    Bielefeld Graduate School in History and Sociology (BGHS), Bielefeld University, Germany.
    Ul Hassan, Mahmood
    Uppsala University, Sweden.
    Nyberg, Anna
    Uppsala Univ, Dept Publ Hlth & Caring Sci, Hlth Equ & Working Life, Uppsala, Sweden.
    Workplace gender harassment, illegitimate tasks, and poor mental health: Hypothesized associations in a Swedish cohort2022In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 315, article id 115520Article in journal (Refereed)
    Abstract [en]

    Workers exposed to gender harassment and illegitimate tasks may experience adverse mental health outcomes such as depression and burnout. However, the longitudinal effects and the complex interrelationships between these variables remain largely unexplored. We investigated the cross-lagged relationships between gender harassment, illegitimate tasks, and mental health outcomes among working adults in Sweden over a period of two years, as well as the gender differences in the cross-lagged effects. Additionally, the study examined whether illegitimate tasks mediated the relationship between gender harassment and negative mental health outcomes over time. Data were drawn from the Swedish Longitudinal Occupational Survey of Health (SLOSH), covering 2796 working men and 4110 working women in a two-wave analysis from 2018 to 2020. We employed a structural equation model to examine the cross-lagged effects and the mediating effect between gender harassment, illegitimate tasks, and mental health outcomes over time. Furthermore, we applied a multigroup analysis to determine gender differences in the cross-lagged effects.

    The results showed statistically significant cross-lagged relationships (forward, reverse, and reciprocal) between gender harassment, illegitimate tasks, and mental ill-health. There were statistically significant gender differences in these cross-lagged relationships (burnout: 

    , p < 0.01; depression: , p < 0.01). Initial illegitimate tasks mediated the relationship between gender harassment and mental ill-health outcomes over time. The gender differences in the interrelationships between gender harassment, illegitimate tasks, and mental ill-health outcomes among workers in Sweden indicate that policies, regulations, and interventions that address these exposures in organisations must be tailored to benefit both men and women.

  • 42.
    Modin, Bitte
    et al.
    Centre for Health Equity Studies, Stockholm University/Karolinska Institutet.
    Ostberg, Viveca
    Centre for Health Equity Studies, Stockholm University/Karolinska Institutet.
    Toivanen, Susanna
    Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    Sundell, Knut
    Centre for Health Equity Studies, Stockholm University/Karolinska Institutet.
    Psychosocial working conditions, school sense of coherence and subjective health complaints. A multilevel analysis of ninth grade pupils in the Stockholm area.2011In: Journal of Adolescence, ISSN 0140-1971, E-ISSN 1095-9254, Vol. 34, no 1, p. 129-39Article in journal (Refereed)
    Abstract [en]

    This study explores the psychosocial working conditions of 7930 Swedish 9th grade students, distributed over 475 classes and 130 schools, in relation to their subjective health using multilevel modeling. At the individual level, students with "strained" working conditions in school (i.e. those experiencing a high level of demands in combination with a low level of control) demonstrated significantly worse health compared to students in "low-strain" situations. "Strained" conditions in combination with a weak school-related sense of coherence were especially unfavourable for health. These findings remained significant when support from teachers, school marks, norm-breaking behaviours, family-relations and certain class- and school-contextual conditions were adjusted for. Thus, while demands are an essential part of school work, this study suggests that high levels of control and a strong school-related sense of coherence can protect against the more detrimental effects on health that high demands at school may cause.

  • 43.
    Niedhammer, Isabelle
    et al.
    Research Institute for Environmental and Occupational Health (IRSET), Epidemiology in Occupational Health and Ergonomics (ESTER) Team, Angers, France.
    Milner, Allison
    University of Melbourne, Melbourne School of Population and Global Health, Centre for Health Equity, Melbourne, Australia.
    Witt, Katrina
    Monash University, Turning Point, Eastern Health Clinical School, Fitzroy, Australia.
    Klingelschmidt, Justine
    Santé publique France, Direction Santé Travail, Saint-Maurice, France.
    Khireddine-Medouni, Imane
    Santé publique France, Direction Santé Travail, Saint-Maurice, France.
    Alexopoulos, Evangelos C
    Occupational Health Unit, “IASO” General Hospital, Athens, Greece.
    Toivanen, Susanna
    Stockholm University, Centre for Health Equity Studies, Stockholm, Sweden..
    Chastang, Jean-François
    Research Institute for Environmental and Occupational Health (IRSET), Epidemiology in Occupational Health and Ergonomics (ESTER) Team, Angers, France.
    LaMontagne, Anthony D
    Deakin University, Centre for Population Health Research, School of Health & Social Development, Geelong, Australia.
    Response to letter to the editor from Dr Rahman Shiri: The challenging topic of suicide across occupational groups.2018In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 44, no 1, p. 108-110, article id 3698Article in journal (Other academic)
    Abstract [en]

    We thank Dr Rahman Shiri (1) for his careful reading of our systematic review and meta-analysis on suicide among agricultural, forestry, and fishery workers (2). Our paper had the objective of providing a pooled effect size of suicide for this occupational group. Suicide is a crucial issue in public and occupational health. Suicide has a multifactorial etiology and recent systematic reviews and meta-analyses have pointed out the role of occupational exposures, mainly psychosocial work stressors, as risk factors for suicide (3, 4). Suicide is a very rare event in the general population and still more seldom in the working population. Indeed, unemployed and economically inactive people have a higher risk of suicide compared to employed people (5, 6). However, the total number of suicides is greater in the employed population than among the economically inactive or unemployed (6). Shiri's letter (1) questioned several aspects of our review and meta-analysis. One comment related to the single reference database used in our review and a suggestion that our review could not be considered to be systematic. The review was based on Medline because our main interest was in quantitative epidemiologic studies. This is the largest database for biomedical literature and we would argue the most pertinent. Furthermore, we checked the reference lists of the most recent papers and literature reviews, and Shiri did not report any paper that was missing. No review, whether searching one or more databases, can expect to be totally exhaustive. There may always be missing studies, especially if we consider grey literature. Thus we assert that our review was systematic, while acknowledging that it may not be perfectly comprehensive. Shiri suggested an absence of quality assessment of the studies included in our meta-analysis. First, quality was considered in the context of our comments in the discussion section. Second, as suggested by Rothman et al (7), quality assessment was replaced by regression analyses of the effect of each quality item (study characteristics, ie, study design, effect measure, reference group, and adjustment). Third, because most studies included in this review were based on objective data (census, administrative, or register data), they were free of many of the sources of bias that exist in studies where information on exposure and outcome must be collected from participants. Consequently, many of the items related to quality were not pertinent, such as response and follow-up rates, coverage and representativeness of the sample, selection, etc. Contrary to what Shiri suggested, all study designs can be informative in this topic because all of them are able to provide an unbiased estimate of the effect size. In addition, the prospective and case-control studies may have shortcomings. For example, we excluded five studies including three prospective and case-control studies in the sensibility analysis because the group of interest was defined on the basis of the exposure to chemicals (pesticides) rather than job title. Our choice to retain the least adjusted models was justified because aggregated data were used for the meta-analysis. Therefore, unless all included studies adjusted for the same covariates measured in the same way, adjusted estimates cannot be meaningfully provided in an aggregate data meta-analysis. In addition, as the objective was above all descriptive and not etiological or explanatory, and as it is the norm in the exploration of social inequalities in health (8), the results from the least (gender- and age-) adjusted models were in line with the objective. Indeed, including more adjustment variables could lead to overadjustment as they may be intermediate variables on the causal pathways between occupation and suicide. Our strategy was in line with previous meta-analyses on similar topics (9-11). Consequently, we would argue that our results are not likely to be largely due to confounding, contrary to the comment by Shiri. Indeed, the study of the contribution of underlying factors in explaining social inequalities in health outcomes is a fully-fledged topic of research (12-15), but this is relevant research to conduct after demonstrating that inequalities exist between social or occupational groups. Several of Shiri's comments were about statistical aspects of our analyses. First, it was suggested that we did not correctly extract the confidence intervals for the estimates of several studies. We disagree. We used the STATA metan suite of commands using log-transformed effect sizes and standard errors. Our figure 1 and the values of effect sizes and confidence intervals were provided by STATA, this explains why there may be small differences in these values compared with the results published in some studies. Using log-transformed effect sizes and confidence intervals, the analysis provided the same results. Second, our subgroup comparison was based on subsamples that were independent. As not all studies provided information for these subgroups, each subgroup was treated as a unit of analysis. This strategy allows the use of all relevant subgroups and comparisons between them (16). Third, we were also criticized for the use of random-effects models. Random-effects models are generally more plausible for meta-analysis based on studies from the published literature, because the fixed-effect model assumed that the entire corpus of literature has been obtained, ie, that every study has been or ever will be written on the topic has been included, which is an implausible assumption. We also assumed differences in effect size between studies and between subgroups, and the use of random-effects models was consistent with such an assumption. However, random-effects models produce wider confidence intervals compared to fixed-effect models (16). These models are thus more conservative, making our results all the more robust. One of Shiri's comments related to the reference group used in the studies for the comparison of agricultural, forestry, and fishery workers. Although we reported that the studies using a specific occupational group as reference group provided a higher effect size than the studies using other reference groups, we did not explicitly recognize and state in the paper that the results for Japan were based on two studies using a specific occupational group as reference; we concede that this may explain why we found a much more elevated effect size for Japan. Shiri's results (1) allow to conclude that the difference between Japan and the other geographic areas could be explained by the choice of reference group-we are grateful to him for raising this point. However, we would note that the effect size of suicide was still elevated and significant for agricultural, forestry, and fishery workers even after this change in the reference group for these two studies. Nevertheless, the choice of the optimal reference group is not obvious. If we consider the general population as the reference group, as unemployed people and economically inactive people (including people who may not be working due to illness or disability) are part of it and have a higher risk of suicide than employed people, the effect size provided by the nine studies using the general population as the reference is likely to be underestimated, which may contribute to an underestimation of the observed effect size of suicide among agricultural, forestry, and fishery workers in our study. The comparison was made in our paper with the other occupational groups (ie, the working population except the group of interest) as the reference, which was used by nine other studies, but this did not allow to determine the exact rank of the group of interest in the occupational hierarchy. Another relevant choice would have been to retain the group with the lowest suicide risk (for example, the high-skilled occupational group) as the reference, which would have led to a much higher effect size of suicide for agricultural, forestry, and fishery workers. To conclude, as statistical power in detecting differences between subgroups may be low in subgroup analyses and meta-regression, the absence of significant results according to subgroups found in our results cannot be interpreted as evidence that the effect size is the same across subgroups. Consequently, our meta-analysis reporting a significant excess of risk of suicide among agricultural, forestry, and fishery workers may also be a good incentive for more research among this group of workers to (i) confirm this observed excess of risk using differing methodological approaches to meta-analysis and (ii) explore the potential differences within this group and the underlying factors that may explain this excess of risk. References 1. Shiri R. Suicide among agricultural, forestry, and fishery workers. Scand J Work Environ Health - online first. https://doi.org/10.5271/sjweh.3697 2. Klingelschmidt J, Milner A, Khireddine-Medouni I, Witt K, Alexopoulos EC, Toivanen S, et al. Suicide among agricultural, forestry, and fishery workers: a systematic literature review and meta-analysis. Scand J Work Environ Health - online first. https://doi.org/10.5271/sjweh.3682 3. Milner A, Witt K, LaMontagne AD, Niedhammer I. Psychosocial job stressors and suicidality: a meta-analysis and systematic review. Occup Environ Med - online first. https://doi.org/10.1136/oemed-2017-104531 4. Leach LS, Poyser C, Butterworth P. Workplace bullying and the association with suicidal ideation/thoughts and behaviour: a systematic review. Occup Environ Med. 2017;74(1):72-9. https://doi.org/10.1136/oemed-2016-103726 5. Milner A, Page A, LaMontagne AD. Long-term unemployment and suicide: a systematic review and meta-analysis. PLoS One. 2013;8(1):e51333. https://doi.org/10.1371/journal.pone.0051333 6. Milner A, Morrell S, Lamontagne AD. Economically inactive, unemployed and employed suicides in Australia by age and sex over a 10-year period: what was the impact of the 2007 economic recession? Int J Epidemiol. 2014;43(5):1500-7. https://doi.org/10.1093/ije/dyu148 7. Rothman KJ, Greenland S, Lash TL. Modern Epidemiology - Third Edition. Philadelphia: Wolters Kluwer Health - Lippincott Williams & Wilkins; 2008. 8. Lundberg I, Hemmingsson T, Hogstedt C. Work and social inequalities in health in Europe. Brussels: P.I.E. Peter Lang SA; 2007. 9. Milner A, Spittal MJ, Pirkis J, Lamontagne AD. Suicide by occupation: systematic review and meta-analysis. Br J Psychiatry. 2013;203(6):409-16. https://doi.org/10.1192/bjp.bp.113.128405 10. Lorant V, Deliege D, Eaton W, Robert A, Philippot P, Ansseau M. Socioeconomic inequalities in depression: a meta-analysis. Am J Epidemiol. 2003;157(2):98-112. https://doi.org/10.1093/aje/kwf182 11. Grittner U, Kuntsche S, Gmel G, Bloomfield K. Alcohol consumption and social inequality at the individual and country levels--results from an international study. Eur J Public Health. 2013;23(2):332-9. https://doi.org/10.1093/eurpub/cks044 12. Niedhammer I, Bourgkard E, Chau N. Occupational and behavioural factors in the explanation of social inequalities in premature and total mortality: a 12.5-year follow-up in the Lorhandicap study. Eur J Epidemiol. 2011;26(1):1-12. https://doi.org/10.1007/s10654-010-9506-9 13. Niedhammer I, Chastang JF, David S, Kelleher C. The contribution of occupational factors to social inequalities in health: findings from the national French SUMER survey. Soc Sci Med. 2008;67(11):1870-81. https://doi.org/10.1016/j.socscimed.2008.09.007 14. Chazelle E, Lemogne C, Morgan K, Kelleher CC, Chastang JF, Niedhammer I. Explanations of educational differences in major depression and generalised anxiety disorder in the Irish population. J Affect Disord. 2011;134(1-3):304-14. https://doi.org/10.1016/j.jad.2011.05.049 15. Niedhammer I, Lesuffleur T, Coutrot T, Chastang JF. Contribution of working conditions to occupational inequalities in depressive symptoms: results from the national French SUMER survey. Int Arch Occup Environ Health. 2016;89(6):1025-37.https://doi.org/10.1007/s00420-016-1142-6 16. Borenstein M, Hedges LV, Higgins JPT, Rothstein HR. Introduction to meta-analysis: John Wiley & Sons, Ltd. ISBN: 978-0-470-05724-7; 2009. https://doi.org/10.1002/9780470743386.

  • 44.
    Nyberg, Anna
    et al.
    Stockholm University, Stockholm, Sweden.
    Johansson, Gun
    Karolinska Institutet, Stockholm, Sweden..
    Westerlund, Hugo
    Stockholm University, Stockholm, Sweden.
    Rostila, Mikael
    Stockholm University, Stockholm, Sweden.
    Toivanen, Susanna
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Stockholm University, Stockholm, Sweden.
    Status incongruence in human service occupations and implications for mild-to-severe depressive symptoms and register-based sickness absence: A prospective cohort study.2020In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 46, no 2, p. 209-217Article in journal (Refereed)
    Abstract [en]

    Objective This study aimed to investigate the hypothesis that negative status incongruence may contribute to explain higher risk of mental ill-health and sickness absence in human service occupations (HSO). Methods Participants from the Swedish Longitudinal Occupational Survey of Health who responded to questionnaires in both 2014 and 2016 (N=11 814; 42% men, 58% women) were included. Status incongruence between register-based educational level and subjective social status was assessed. The association between employment in a HSO and status incongruence was estimated in linear regression analyses adjusted for age, income, work hours, sickness absence, childcare, and job qualification match. The prospective associations between status incongruence and mild-to-severe depressive symptoms and register-based sickness absence ≥31 days respectively were estimated with logistic regression analyses in models adjusted for age and outcomes at baseline. All analyses were stratified by gender. Results Employment in a HSO was associated with more negative status incongruence in both genders [standardized coefficient men 0.04, 95% confidence interval (CI) 0.02-0.07; women 0.06, 95% CI 0.04-0.09]. More negative status incongruence was furthermore associated with higher odds of mild-to-severe depressive symptoms (men OR 1.18, 95% CI 1.08-1.29; women OR 1.17, 95% CI 1.09-1.26) and sickness absence ≥31 days (men OR 1.40, 95% CI 1.23-1.59; women OR 1.17, 95% CI 1.07-1.28) two years later. Conclusion Status incongruence is somewhat higher among HSO than other occupations and associated with increased odds of depressive symptoms and sickness absence.

  • 45.
    Nyberg, Anna
    et al.
    Uppsala University, P.O. Box 564, SE-751 22 Uppsala, Sweden.
    Peristera, Paraskevi
    Stockholm University, SE-106 91 Stockholm, Sweden.
    Toivanen, Susanna
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Johansson, Gun
    Karolinska Institutet, SE-113 65 Stockholm, Sweden.
    Does Exposure to High Job Demands, Low Decision Authority, or Workplace Violence Mediate the Association between Employment in the Health and Social Care Industry and Register-Based Sickness Absence? A Longitudinal Study of a Swedish Cohort2021In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 19, no 1, article id 53Article in journal (Refereed)
    Abstract [en]

    Background: The aim of this paper was to investigate if job demands, decision authority, and workplace violence mediate the association between employment in the health and social care industry and register-based sickness absence. Methods: Participants from the Swedish Longitudinal Occupational Survey of Health who responded to questionnaires in 2006–2016 (n = 3951) were included. Multilevel autoregressive cross-lagged mediation models were fitted to the data. Employment in the health and social care industry at one time point was used as the predictor variable and register-based sickness absence >14 days as the outcome variable. Self-reported levels of job demands, decision authority, and exposure to workplace violence from the first time point were used as mediating variables. Results: The direct path between employment in the health and social care industry and sickness absence >14 days was, while adjusting for the reverse path, 0.032, p = 0.002. The indirect effect mediated by low decision authority was 0.002, p = 0.006 and the one mediated by exposure to workplace violence was 0.008, p = 0.002. High job demands were not found to mediate the association. Conclusion: Workplace violence and low decision authority may, to a small extent, mediate the association between employment in the health and social care industry and sickness absence. 

  • 46.
    Oksala, Tarkko
    et al.
    Aalto University, Otakaari, Finland.
    Toivanen, Susanna
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Oksala, Aino
    Stockholm University, Stockholm, Sweden.
    Architectural Cognition Sociology2018In: Sociology and Anthropology, ISSN 2331-6179, E-ISSN 2331-6187, Vol. 6, no 7, p. 579-588Article in journal (Refereed)
    Abstract [en]

    The aim of this paper is to promote Architectural Sociology keeping cognition in focus. Firstly architecture, cognition and society are considered in their relationships. Secondly associations promoting cognition, its study and extensions of architectural cognition are discussed. This all is made in order to form a clear conceptual basis to understand architectural action in socio-psychological reality. This is tested by using architectural goal setting as example. Application of the frame in solving recent challenges is commented.

  • 47.
    Pena Gralle, Ana Paula Bruno
    et al.
    Sergio Arouca National School of Public Health, Oswaldo Cruz Foundation, Brazil.
    Barbosa Moreno, Arlinda
    Sergio Arouca National School of Public Health, Oswaldo Cruz Foundation, Brazil.
    Lopes Juvanhol, Leidjaira
    Sergio Arouca National School of Public Health, Oswaldo Cruz Foundation, Brazil.
    Mendes da Fonseca, Maria de Jesus
    Sergio Arouca National School of Public Health, Oswaldo Cruz Foundation, Brazil.
    Prates Melo, Enirtes Caetano
    Sergio Arouca National School of Public Health, Oswaldo Cruz Foundation, Brazil.
    Antunes Nunes, Maria Angélica
    School of Medicine, Federal University of Rio Grande do Sul, Brazil.
    Toivanen, Susanna
    Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    Griep, Rosane Härter
    Sergio Arouca National School of Public Health, Oswaldo Cruz Foundation, Brazil.
    Job strain and binge eating among Brazilian workers participating in the ELSA-Brasil study: does BMI matter?2017In: Journal of Occupational Health, ISSN 1341-9145, E-ISSN 1348-9585, Vol. 59, no 3, p. 247-255Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To assess the association between job strain and binge eating as well as the effect-modifying influence of body mass index (BMI) on this association.

    METHODS: A total of 11,951 active civil servants from the multicenter Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) was included in this cross-sectional analysis. Job strain was assessed using the Demand-Control-Support Questionnaire. Binge eating was defined as eating a large amount of food with a sense of lack of control over what and how much is eaten in less than 2 hours at least twice a week. Multiple logistic regression was used to determine the association between binge eating and job strain as well as its interaction with BMI.

    RESULTS: After adjustment, and using low-strain job as the reference category, binge eating was associated with high-strain job (high demand/low control: odds ratio [OR]=1.58, 95% confidence interval [CI] 1.26-1.98), active job (high demand/high control: OR=1.35, 95% CI 1.07-1.70), and passive job (low demand/low control: OR=1.24, 95% CI 1.01-1.53). Psychological job demands were positively associated with binge eating (OR=1.04, 95% CI 1.01-1.07), while greater job control and social support at work were each inversely associated with binge eating (OR=0.95, 95% CI 0.92-0.97 and OR=0.96, 95% CI 0.94-0.98, respectively). BMI modified the association between job strain and binge eating: Heavier psychological job demands were associated with higher odds of binge eating among obese participants, while a stronger inverse association between job control and binge eating was seen among slimmer participants.

    CONCLUSIONS: Job strain increases the odds of binge eating and this association is modified by BMI.

  • 48.
    Petersson Troije, Charlotte
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Department of Urban Studies, Malmö University, Malmö, Sweden.
    Lisberg Jensen, Ebba
    Malmö University Malmö , Sweden.
    Stenfors, Cecilia U. D.
    Stockholm University Stockholm, Sweden.
    Bodin Danielsson, Christina
    School of Architecture and the Built Environment, Royal Institute of Technology Stockholm, Sweden.
    Hoff, Eva Viola
    Lund University Lund, Sweden.
    Mårtensson, Fredrika
    Swedish university of agricultural sciences in Alnarp Sweden Alnarp, Sweden.
    Toivanen, Susanna
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Outdoor Office Work: An Interactive Research Project Showing the Way Out2021In: Frontiers in Psychology, E-ISSN 1664-1078, Vol. 12, article id 636091Article in journal (Refereed)
    Abstract [en]

    The physical boundaries of office work have become increasingly flexible. Work is conducted at multiple locations outside the office, such as at clients’ premises, at home, in cafés, or when traveling. However, the boundary between indoor and outdoor environment seems to be strong and normative regarding how office work is performed. The aim of this study was to explore how office work may be conducted outdoors, understanding how it is being experienced by office employees and identifying its contextual preconditions. Based on a two-year interactive research project, the study was conducted together with a Swedish municipality. Fifty-eight participants engaged in the collaborative learning process, including 40 half-day workshops and reflective group discussions, co-interviews, and participants’ independent experimentation of bringing work activities outdoors. Data was collected via interviews, group discussions and a custom-made mobile application. The results showed that a wide range of work activities could be done outdoors, both individually and in collaboration with others. Outdoor work activities were associated with many positive experiences by contributing to a sense of well-being, recovery, autonomy, enhanced cognition, better communication, and social relations, but also with feelings of guilt and illegitimacy. Conditions of importance for outdoor office work to happen and function well were found in the physical environment, where proximity to urban greenspaces stood out as important, but also in the sociocultural and organizational domains. Of crucial importance was managers’ attitudes, as well as the overall organizational culture on this idea of bringing office work outdoors. To conclude, if working life is to benefit from outdoor office work, leaders, urban planners and policymakers need to collaborate and show the way out.

  • 49.
    Portela, Luciana Fernandes
    et al.
    National School of Public Health (ENSP/Fiocruz), Brazil.
    Kröning Luna, Caroline
    Oswaldo Cruz Institute (IOC/Fiocruz), Brazil.
    Rotenberg, Lúcia
    Oswaldo Cruz Institute (IOC/Fiocruz), Brazil.
    Silva-Costa, Aline
    Oswaldo Cruz Institute (IOC/Fiocruz), Brazil.
    Toivanen, Susanna
    Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    Araújo, Tania
    State University of Feira de Santana, Brazil.
    Griep, Rosane Härter
    Oswaldo Cruz Institute (IOC/Fiocruz), Brazil.
    Job Strain and Self-Reported Insomnia Symptoms among Nurses: What about the Influence of Emotional Demands and Social Support?2015In: BioMed Research International, ISSN 2314-6133, E-ISSN 2314-6141, Vol. 2015, article id 820610Article in journal (Refereed)
    Abstract [en]

    Job strain, derived from high psychological demands and low job control, is associated with insomnia, but information on the role of emotional demands and social support in this relationship is scarce. The aims of this study were (i) to test the association between job strain and self-reported insomnia symptoms, (ii) to evaluate the combination of emotional demands and job control regarding insomnia symptoms, and (iii) to analyze the influence of social support in these relationships. This cross-sectional study refers to a sample of nurses (N = 3,013 and N = 3,035 for Job Strain and Emotional demand-control model, resp.) working at public hospitals in Rio de Janeiro, Brazil. Data were collected through a self-report questionnaire. The prevalence of insomnia symptoms was 34.3%. Job strain was associated with increased odds for insomnia symptoms (OR: 2.20); the same result was observed with the combination of emotional demands and low job control (OR: 1.99). In both models, the inclusion of low social support combined with high demands and low job control led to increased odds for insomnia symptoms, compared to groups with high social support from coworkers and supervisors. Besides job strain, the study of emotional demands and social support are promising with regards to insomnia symptoms, particularly among nurses.

  • 50.
    Ramberg, Joacim
    et al.
    Department of Special Education, Stockholm University, Sweden.
    Brolin Låftman, Sara
    Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Sweden.
    Nilbrink, Jannike
    Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Sweden.
    Olsson, Gabriella
    Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Sweden.
    Toivanen, Susanna
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Sweden.
    Job strain and sense of coherence: Associations with stress-related outcomes among teachers2022In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 50, no 5, p. 565-574Article in journal (Refereed)
    Abstract [en]

    Background: Teachers constitute an occupational group experiencing high levels of stress and with high sick-leave rates. Therefore, examining potentially protective factors is important. While prior research has mainly focused on the link between teachers’ own experiences of their work environment and stress-related outcomes, it is also possible that colleagues’ perception of the work environment and their possibilities for dealing with work-related stress contribute to influencing individual teachers’ stress. Aim: The aim of this study was to investigate how teachers’ reports of high job strain (i.e. high demands and low control) and sense of coherence (SOC), as well as the concentration of colleagues reporting high strain and high SOC, were associated with perceived stress and depressed mood. Methods: The data were derived from the Stockholm Teacher Survey, with information from two cross-sectional web surveys performed in 2014 and in 2016 (N=2732 teachers in 205 school units). Two-level random intercept linear regression models were performed. Results: High job strain at the individual level was associated with higher levels of perceived stress and depressed mood, but less so for individuals with high SOC. Furthermore, a greater proportion of colleagues reporting high SOC was associated with lower levels of perceived stress and depressed mood at the individual level. Conclusions: High SOC may be protective against work-related stress among teachers. Additionally, the proportion of colleagues reporting high SOC was related to less individual stress, suggesting a protective effect of school-level collective SOC.

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