Date of Completion

5-11-2013

Embargo Period

5-22-2013

Advisors

Martin G. Cherniack, MD, MPH; Michael Copenhaver, PhD; Tania. Huedo-Medina, PhD

Field of Study

Allied Health

Degree

Master of Science

Open Access

Campus Access

Abstract

ABSTRACT

Statement of the Problems: Correctional officers have an increased risk for the development of “stress-related health problems” and a decreased life expectancy in part credited to stress levels (Ghaddar et al. 2008). Officer stress can be attributed to contact with inmates, long and unpredictable shift work, unanticipated emergency codes, the sedentary nature of the job, low control and high effort to reward imbalance (Hannerz et al., 2004, Oginska-Bulki, 2005, Senol-Durak et al., 2006). Such stressors decrease the likelihood of partaking in a healthy lifestyle, including the consumption of nutritious foods and regular physical activity. Since the “high-stress” environment of the correctional facility is not conducive to healthy living it is important to understand how the environment affects the lifestyle of the employees and to determine the specific variables that affect the health of the officers. In this study we performed a health risk assessment (HRA) to identify the occupational variables related to weight gain.

Purpose: The purpose of this study is to evaluate 3-year weight gain in a cohort of correctional employees representing a high stress occupation. Furthermore this study aims to evaluate the relationship between weight gain and the stressors that employees working within high stress environments share and how other health indictors may be interacting and predicting weight gain.

Study Design: Longitudinal observational

Sample Size and Composition: All employees (correctional officers, lieutenants, captain, deputy wardens, wardens, correctional treatment officers, counselors, support staff and medical staff) of two correctional facilities, with similar characteristics, were invited to participate. One hundred and six employees participated and completed the HRA survey at baseline and year three.

Measures Utilized: Age, Gender, Job, Job Tenure, Body Weight, Body Mass Index, Blood Pressure, Nutrition Score, Fitness Score, Adequacy of Sleep, Stress Signals, Coping Status, Emotional Problems, Sick Days, Job Satisfaction, and Shift were used to evaluate changes in weight over a three-year period.

Analysis Method: Descriptive statistics were obtained on all of the collected data for year 1 and year 3. Mean and standard deviations were reported for quantitative data. Percentages and frequencies were reported for categorical as well as demographic characteristics at both baseline and year three. Normality (using Shapiro-wilk test, quantile probability plot, and histogram), linear (using scatter plots and correlations), and variance homogeneity assumptions (using Levene’s test) were tested to run general linear model using ANOVAs and multivariate regressions. A significance levels of α=0.05 was considered for all the bivariate analysis, Fisherʼs least Significant Difference Tests (Fisherʼs LSD) was used for multiple comparisons tests, and Kruskal-

Wallis test when normality was not met. Regression models were performed on significant interaction variables.

Results: The sample of employees who participated in this study was largely overweight or obese (93.97% of males and 73.92% of females at baseline). Over the course of a three-year period, the obesity prevalence rates raised from 52% to 54%. Our statistical model proved baseline variables of stress including, gender, age, job position, job satisfaction, “emotional problems” and “stress signals”, to be strong predictors of weight gain over a three-year period. The way in which stress affects health and weight may be related to how stress affects coping and lifestyle choices.

Conclusions:

The results of this study indicate that there is a relationship between occupational factors, stress and weight gain. After data analysis we came to 6 conclusions:

• On average the female correctional employees show higher drop in weight from year 1 to year 3, controlling for age, job satisfaction, emotional problems stress signals and job position.

• A unit increases in age is associated with an increase in weight from year 1 to year 3.

• Correctional staff show a significant increase in weight from year 1 to year 3 compared to support staff, controlling for gender, age, job satisfaction, emotional problems and stress signals.

• Correctional employees who are not satisfied with their job show a significant increase in weight from year 1 to year 3 compared to those who are satisfied, controlling for gender, age, emotional problems, stress signals and job position.

• Correctional employees with high emotional problems show a significant increase in weight from year 1 to year 3 compared to those who do not score high on emotional problems, controlling for gender, age, job satisfaction, stress signals and job position.

• Relative to employees who have high stress signals (more than one stress factor), while other predictors in the model are held fixed, employees with lower stress signals (zero or one stress factors) are each more likely to show an increase in weight from Time 1 to Time 3.

Future studies may want to address the effect of stress, age, gender, job position, and job satisfaction on weight gain when developing and implementing a successful weight loss programs within a high stress environment. Future studies may also test a complex model with mediators and models using other outcomes besides weight gain.

Major Advisor

Dr. Pouran Faghri, MD, MS, FACSM

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