Matthew Brennan, MPH, Department of Medicine, UConn Health, Farmington, CT; Rajashree Kotejoshyer, PhD, Department of Medicine, UConn Health, Farmington, CT; Sara Namazi, PhD, Department of Health Sciences, Springfield College, Springfield MA; Stanquinto Sudduth, BS, Chief Steward AFSCME Local 391, Connecticut State Prison Employee Union; Eric Tokarzewski, BA, Correctional Officer, Connecticut Department of Corrections; Robert A. Henning, PhD, Department of Psychological Sciences, University of Connecticut, Storrs, CT; James Hughes, MS, Department of Psychological Sciences, University of Connecticut, Storrs, CT; Martin Cherniack, MPH, MD, Department of Medicine, UConn Health, Farmington, CT
Purpose/Objectives
This study compared the effectiveness and methods of functioning of two types of teams of frontline workers engaged in intervention planning: facility-based teams versus a multi-site -based team. The goal was to determine which offered a more efficient and sustainable approach for improving the well-being of correctional employees.
Background
Correctional employees are known to be at increased risk for adverse physical and mental conditions due to working under stressful conditions. Chronic health problems are prevalent among correctional officers, and their health status declines with increasing tenure.1,2
Since 2006, The Center for the Promotion of Health in the New England Workplace’s Health Improvement Through Employee Control (HITEC) project has collaborated with the Connecticut Department of Corrections (DOC) and associated labor organizations on improving the health and well-being of correctional staff (CS). HITEC utilized a Participatory Action Research (PAR) methodology to establish, train and advise design teams (DTs) consisting of front-line CS that create interventions to improve staff health and well-being.
Within the DOC, there are three local unions for front-line CS. Each local was tasked with creating a facility-based DT or multi-site based DT. Two unions chose the facility-based approach; one opted to create a team of staff from several facilities represented by their union.
Methods
DTs were trained to utilize the Intervention Design and Analysis Scorecard (IDEAS) Tool to create, implement and evaluate workplace interventions. 3 Members of each DT were recruited by their unions. Two facility-based DTs started in 2018; the multi-site based DT started in 2019. Each DT consisted of 6-10 members with a designated facilitator and co-facilitator.
Researcher process surveys and meeting notes were used to compare the process fidelity, efficacy and challenges of each DT.
Findings
Each of the DTs held approximately 16 meetings prior to presenting intervention proposals to their respective facility administrators. The two facility-based teams meet biweekly over ten months; the multi-site based DT met weekly for four months. In general, the size of DTs remained constant despite turnover. One facility-based team stopped completely after presenting intervention proposals due to internal union disagreements and member transfers.
The COVID-19 pandemic impeded meetings due to restrictions on physical meetings and accessibility challenges to virtual meetings; these challenges were more prevalent in facility-based DTs because the union-based DT could use union hours to meet. Most members of facility-based DTs held specialized positions at the facility with set schedules; normally an advantage to meeting but an obstacle to virtual meetings during pandemic restrictions.
Prior to the pandemic, the facility-based DT successfully implemented interventions for their staff: a health fair, two outdoor structures to protect staff during inclement weather, a report writing room, healthy snacks, a decompression room. Report writing training is pending.
The multi-site based DT team began work to establish report writing rooms and locations to decompress following violent incidents; however, pandemic restrictions prevented implementation. This DT then concentrated on developing staff trainings on mental health and consistency in report writing, and is collaborating with the DOC Training Academy to finalize a facility-based officer training program.
Discussion
Both types of DTs successfully identified major concerns that impacted the mental health, and designed and implemented interventions, empowering DTs to take an active role in improving the wellbeing of CS.
Facility-based DTs had the advantage of all members knowing each other as well knowing all personnel and logistics of their facilities but meeting attendance was sometimes restricted because positions at correctional facilities cannot be unmanned, requiring relief coverage.
Members in the multi-site based DT were recruited from five facilities and were not all acquainted but met weekly due to flexible union hours. Increased meeting frequency promoted teamwork and expedited intervention planning.
A challenge of implementing DTs in this workforce is that corrections organization is built on hierarchy. Initiatives built from the ground level up are not part of the organizational structure and functioning. Balancing front-line worker autonomy with supervisor support and approval is not easily achieved.4,5 Transition in facilities leadership through promotion, transfer or retirement, affected both DTs. Facility-based DTs relied on supervisor approval to meet. While some supervisors were supportive, others were hesitant or unwilling to provide relief coverage for all members to meet. The multi-site based team conducted their meetings in the union hall, but required the support of administration as each facility to conduct their trainings. Similar to the facility-based team, the approval was inconsistent.
Conclusions
Each DT structure successfully utilized the HWPP process to identify and address wellbeing issues within corrections. Facility-based DTs initially had the advantage of increased familiarity with each other and their building; the multi-site based DT had the advantage of meeting times and space which expedited intervention planning despite pandemic restrictions. Both types of DTs require active support from all levels at the organization.