Explain how various audiences might perceive the author’s intent and message

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References

Elliot, D., Kuehl, K., Ghaziri, M. E., & Chemiack, M. (2015). Stress and correction: addressing the safety and well being of correctional officers. Corrections Today, (4), 40. Retrieved from https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=edsgea&AN=edsgcl.422624448&site=eds-live&scope=site

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To prepare:

• Select an article from either the Walden Library or the Internet related to public policy and administration and your field of interest.
• Consider how different audiences could interpret the selected article. Pay particular attention to the quality of evidence that the author presents.

By Day 7

Submit a 1-page evaluation of the article you selected. In your evaluation, be sure to do the following:

• Evaluate the quality of evidence, appropriateness of the content and writing style for the target audience, and the author’s potential bias. Then, explain whether the article meets professional standards for scholarly writing and why.
• Explain how various audiences might perceive the author’s intent and message.
• Explain how you might revise the article to make it more appropriate for an international audience.

  July/August 2015 Corrections Today — 41

  Kerry Kuehl, M.D., Dr.P.H., was the lead investigator in the NIOSH-funded “Safety and Health Improve- ment: Enhancing Law Enforcement Departments” study,7 which established an evidence-based safety and health program for municipal and county law enforcement officers. It was natural to extend that work to COs. An initial step compared survey find- ings from COs at prisons of different security levels in an effort to characterize staff and use that informa- tion to match facilities in a prospective trial of a pro- gram to improve COs’ TWH. Despite similar years on the job across sites, stress levels, body weight, alco- hol intake and sick days all increased as the security level intensified. However, even at the minimum- security sites, COs had higher body weights and more cardiovascular risk factors than the average police officer. Findings pointed to a gradient of increasing stress relating to greater health problems.

  Tim Morse, Ph.D., and colleagues from the Cen- ter for Promoting Health in the New England Work- place (CPH-NEW) used surveys, focus groups and physical assessments to understand the health of COs from two prisons.8 Morse and his colleagues found COs had more obesity than the U.S. aver- age. Only 15 percent of COs were in the normal weight range, about half what is found in the gen- eral adult population. The COs’ interview data was remarkable for findings of stress relating to poor dietary habits and barriers to regular exercise. Kuehl’s subsequent study among Oregon COs found only 8 percent of West Coast COs were at healthy body weights. In addition, the New England investigators uncovered high levels of depression among COs.9 In general, about 15 percent of aver- age adults score in the depressed range, while for these COs, that number was more than 30 per- cent. The high stress and depression levels relat- ed to greater work/family conflicts. Like in other professions, correctional work issues tend to spill into life off the job. TWH is about being safe and healthy 24/7, and examining work’s impact — both on and off the job — is an important com- ponent for the work of the TWH Centers of Excellence.

  Stress is Hazardous to Your Heart There are clear links between stress and both

  mental and physical illnesses.10 In particular, high stress increases risks for “metabolic syndrome.” Metabolic syndrome is a collection of cardiovascu- lar risk factors that include central obesity, insulin resistance and elevated blood sugar, hypertension, and abnormal lipid levels with higher triglycerides and lowered HDL (good) cholesterol levels.11 When experienced individually, each of these factors increase the risk for heart disease, and when they

  cluster together, the risks are multiplied. This greatly accelerates the risk for atherosclerosis, so much so that the combination was termed a metabolic syndrome.

  In 2013, the U.S. Department of Justice published a review of stress among COs.12 The document high- lighted the many sources of stress for COs, such as hypervigilance, constant threats of violence, media scrutiny, a closed work environment, understaffing, organizational issues and work/family conflicts. An additional finding from the West Coast prison COs was that their rates of metabolic syndrome were almost twice of that observed among police officers. Precisely how stress leads to metabolic syndrome is not understood. However, it is clear that the best management relates to weight loss, regular exercise, adequate sleep and a healthy diet.

  First National Symposium on the Safety and Well-Being of COs

  In July 2014, researchers from the Pacific North- west and New England were joined by practitioner and research stakeholders, representatives from national health and correctional institutes, union officials and correctional administrators in holding the 2014 National Symposium on Corrections Worker Health. More than 60 individuals attended the day- long meeting, which was webcast to other national participants. The symposium was a first step in what is anticipated to be a growing movement to place the health of COs on the national research agenda.

  The symposium was opened by Oregon Depart- ment of Corrections (DOC) Deputy Director Mitch Morrow. Morrow was a CO for 26 years and rose through the ranks to his current position. He spoke about the recent epidemic of CO suicides and their worker compensation claims being the highest among all state workers. He passionately called for effective strategies to reduce these risks and the need to increase research funding to understand and address COs’ health risks. Keynote speakers included

  40 — July/August 2015 Corrections Today

  Feature

  ubMed is an Internet search engine used to access millions of articles in biomedical and life science literature. Searching “police officers and health” on PubMed yields almost 5,000 articles, and searching “firefighters and health” results in more than 900 citations. However, only 23 articles are identified when searching “correctional officers (COs) and health.” This article is a snapshot of ongoing work and a growing national consortium of individuals interested in advancing the well-being of COs.

  In 2006, the National Institute of Safety and Health (NIOSH) began combining its emphasis on worker safety with workplace health promo- tion for a strategy termed Total Worker HealthTM (TWH).1 Traditionally, safety and health each have received only individual attention. Corrections is a

  profession with clear links among safety, job- related issues and health. Those connections and pressing needs for improvements in both health protection and promotion move COs into the spot- light for promoting TWH.

  Hazards of Correctional Work Correctional work conditions and practices dif-

  fer by facility, region and jurisdiction. As a result, it is difficult to generalize from the small number of available studies to make conclusions about the health of the more than half a million COs in the U.S. However, the picture that emerges from the limited available information is concerning. The authors and others have found that COs have high rates of stress,2 depression,3 suicide,4 obe- sity,5 cardiovascular disease risks and injury.6

  and Corrections: Addressing the Safety and Well- Being of Correctional Officers

  P By Diane Elliot, Kerry Kuehl, Mazen El Ghaziri and Martin Cherniack

  • Maintain a healthy body weight; • Exercise for at least 30 minutes every

  day; • Eat at least five servings of fruits and

  vegetables each day; • Obtain at least seven hours of sleep each

  day; • Promote a culture of wellness and peer

  support; and • Visit your physician for an annual check up.

  Figure 1: Ways to Improve Well-Being

   

   

  42 — July/August 2015 Corrections Today July/August 2015 Corrections Today — 43

  barbed wire fence of security and challenging work structures that require time to build trust, ensure confidentiality and involve all stakeholders to effec- tively impact both systemwide and individual CO issues.

  The objectives of the collaboration among CO investigators, led by El Ghaziri, are placing correc- tions on the agendas of national institutes that con- trol research funds for that work; facilitating the sharing of information among those involved in pro- moting the health and safety of COs; and assisting in the design and conduct of multicenter prospective trials of comprehensive TWH programs for COs. However, findings from a national study are years away, and the well-being of COs cannot wait. In the meantime, the items in Figure 1 are ways COs can apply the same diligence used to protect individuals in the community to protecting the health of COs and correctional facility staff.

  ENDNOTES 1 Schill, A. and L.C. Chosewood. 2013. The NIOSH Total Worker HealthTM program: An overview. Journal of Occupational and Envi- ronmental Medicine, 55(12):S8-S11.

  2 Bower, J. 2013. Correctional officer wellness and safety litera- ture review. Washington, D.C.: U.S. Department of Justice Office of Justice Programs Diagnostic Center. Retrieved from www. ojpdiagnosticcenter.org/sites/default/files/spotlight/download/ NDC_CorrectionalOfficerWellnessSafety_LitReview.pdf.

  3 Obidoa, C., D. Reeves, N. Warren, S. Reisine and M. Cherniack. 2011. Depression and work family conflict among corrections officers. Journal of Occupational and Environmental Medicine, 53(11):1294-1301.

  4 Violanti, J.M., C.F. Robinson and R. Shen. 2013. Law enforcement suicide: A national analysis. International Journal of Emergency Mental Health and Human Resilience, 15(4):289-297.

  5 Morse, T., J. Dussetschleger, N. Warren and M. Cherniack. 2011. Talking about health: Correction employees’ assessments of obsta- cles to healthy heaving. Journal of Occupational and Environmental Medicine, 53(9):1037-1045.

  6 Konda, S., A. Reichard and H. Tiesman. 2012. Occupational inju- ries among U.S. correctional officers, 1999-2008. Journal of Safety Research, 43(3):181-186.

  7 Kuehl, K.S., D.L. Elliot, L. Goldberg, D.P. MacKinnon, B.J. Vila, J. Smith, M. Mioevic, H.P. O’Rourke, M.J. Valente, C. DeFrancesco, A. Sleigh and W. McGinnis. 2014. The safety and health improvement: Enhancing law enforcement departments study: Feasibility and findings. Frontiers in Public Health, 2:38.

  8 Morse, T. et al. 2011.

  9 Obidoa, C. et al. 2011.

  10 Murphy, L.R. 1996. Stress management in work settings: A critical review of the health effects. American Journal of Health Pro- motion, 11(2):112-135.

  11 O’Neill, S. and L. O’Driscoll. 2014. Metabolic syndrome: A clos- er look at the growing epidemic and its associated pathologies. Obesity Review, 16(1):1-12.

  12 Bower, J. 2013.

  13 Violanti, J.M. et al. 2013.

  14 Violanti, J.M., C.M. Burchfiel, D.B. Miller, M.E. Andrew, J. Dorn, J. Wactawski-Wende, C.M. Beighley, K. Pierino, P.N. Joseph, J.E. Vena, D.S. Sharp and M. Trevisan. 2006. The Buffalo Cardio-met- abolic Occupational Police Stress (BCOPS) pilot study: Methods and participant characteristics. Annals of Epidemiology, 16(2):148- 156.

  15 Violanti, J.M. et al. 2013.

  16 Portland State University. 2014. 2014 national symposium on corrections worker health – full version. Retrieved from www. youtube.com/watch?v=Tn8sIbh_CgY&.

  17 Portland State University. 2014. 2014 national symposium on corrections worker health: Conference materials. Portland, Ore.: Portland State University. Retrieved from www.ohsu.edu/xd/ research/centers-institutes/oregon-institute-occupational-health- sciences/oregon-healthy-workforce-center/education-outreach/ upload/Conference-materials-FINALsm.pdf.

  18 Bower, J. 2013.

  19 Robertson, M., R. Henning, N. Warren, S. Nobrega, M. Dove-Steinkamp, L. Tibirica, A. Bizarro and CPH-NEW Research Team. 2013. The intervention design and analysis scorecard: A planning tool for participatory design of integrated health and safety interventions in the workplace. Journal of Occupational and Environmental Medicine, 55(12):86-88.

  Diane Elliot, M.D., and Kerry Kuehl, M.D., Dr.P.H., are professors of medicine in the Division of Health Promotion and Sports Med- icine at Oregon Health and Science University. Both are faculty inves- t i g a t o r s a t t h e O r e g o n Health Workforce Center, a Total Worker HealthTM Center of Excellence fund- ed by the National Insti- tute of Safety and Health. Mazen El Ghaziri, Ph.D.,

  M.P.H., R.N., is a postdoctoral fellow at the Center for the Promotion of Health in the New England Workplace, another Total Worker HealthTM Center of Excellence, and the Division of Occupational and Environmental Medi- cine at the University of Connecticut Health Center. Martin Cherniack, M.D., M.P.H., is a professor of medicine in the Division of Occupational and Environmental Medicine at the University of Connecticut Health Center and co- director of the Center for the Promotion of Health in the New England Workplace.

  Margaret Kitt, M.P.H., M.D., deputy director at NIOSH, and Marie Garcia, Ph.D., a social science analyst in the Justice Systems Research Division at the National Institute of Justice.

  John Violanti, Ph.D., presented information about the increased risk of suicide among COs.13 Violanti served 23 years as a New York state trooper and spent the next 25 years studying the health of police officers. He is best known for the Buffalo Cardio- metabolic Occupational Police Stress (BCOPS) study, a longitudinal study of police officers’ health.14 BCOPS identified the connections among police work, shift schedules, sleep disorders, obesity, car- diovascular risk factors and cancer. More recently, Violanti has turned his attention to the problems of COs. He has documented elevated suicide risks among COs and identified that suicide is part of a much larger problem of stress and emotional strain.15

  Oliver Wirth, Ph.D., a research psychologist at NIOSH, and Jean Meade, M.D., D.V.M., Ph.D., M.P.H., a program council government member at NIOSH, shared their early wellness work with COs. Meade facilitated development of a post-traumatic stress disorder service dog training program in a unique veterans-only prison housing unit. An unanticipated positive outcome of the training was that the COs also felt better when the service dogs were present. That observation resulted in plans to study the ben- efits of human-animal interactions on COs, as well as their inmate trainers. All of the morning symposium presentations are available as free online videos.16

  The afternoon sessions provided a series of inter- active discussions, where participants rotated among content experts to share information. The topics included fatigue management, work/family balance, juvenile corrections, ergonomics, organizational culture, stress and CO safety. Meeting organizers were gratified by the meetings’ outcomes. Martin Cherniack, M.D., M.P.H., executive director of CPH- NEW at the University of Connecticut, remarked, “I was really struck by the enthusiasm and collabo- ration among researchers, union leaders, [COs] and federal officials. Now it’s time for solutions.”

  Kuehl, who coordinated the meeting held in Portland, Ore., noted, “With our findings indicating the high health risks of COs, this is a critical time

  to work with labor and management, and state and federal agencies to make this public safety work- force a high priority for funded research.” Mazen El Ghaziri, Ph.D., M.P.H., R.N., coordinates the consor- tium’s ongoing work and is preparing a conference summary paper, including the roundtable reports. It will join the presentation materials that are cur- rently available online.17 El Ghaziri indicated that the summary paper will lay the groundwork to apply for future grants and advance policies that protect and promote health in this high-risk workforce.

  Conclusion The review of CO stressors concluded that, while

  there are local efforts and recommended best prac- tices, there are no proven effective safety and health programs for COs, and more studies are needed.18 Investigators from both TWH centers are actively working to fill that gap and enhance the safety and well-being of COs. At the Oregon Healthy Workforce Center, Kuehl is analyzing findings from the Oregon DOC study, a randomized trial of a team-centered, peer-led scripted safety and health program among four Oregon facilities. The University of Connecticut’s DOC study builds on its work that early employment years may be a particularly vulnerable time for COs. In addition, its prior studies indicate participatory approaches that involve all stakeholders in identi- fying issues and solutions appear to be more effec- tive.19 The University of Connecticut’s current work includes educational and mentoring activities for new hires, as well as programs for established COs addressing nutrition, fitness, ergonomics and on-the- job injuries. These New England studies are planned to run through 2016.

  Impacting the safety and well-being of COs pres- ents challenges. Working behind prison walls, with- out ongoing interactions with the public, makes COs less visible than other public safety professions, such as emergency medical services, firefighting and law enforcement. In addition, as Violanti emphasized when talking about suicide among police detectives, the “blue line” of law enforcement culture can be difficult to traverse when getting individuals to admit vulnerability, seek out assistance and alter current practices and culture. For COs, the blue line is a

  Impacting the safety and well-being of COs presents challenges. Working behind prison walls, without ongoing interactions with the public, makes COs less visible than other public safety professions,

  such as emergency medical services, firefighting and law enforcement.

   

   

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