Claire E. Smith, Ph.D., Bowling Green State University; Susannah Huang, M.A., Bowling Green State University; Melissa A. Albert, M.A., Bowling Green State University; Samuel T. McAbee, Ph.D., Bowling Green State University

Purpose/Objectives
The present study aims to establish the value of an emerging construct: presenteeism pressure, or organizational pressure to attend work when one’s health would reasonably excuse absence. We seek to demonstrate the incremental validity of presenteeism pressure over related constructs (i.e., presenteeism climate, or the specific career consequences and supervisor and colleague reactions that reinforce being physically present at work) in predicting key well-being (i.e., presenteeism behavior, job engagement) and performance (i.e., organizational citizenship behaviors or OCBs, counterproductive work behaviors or CWBs) outcomes. Based on the Theory of Planned Behavior (Ajzen, 1991), we expect presenteeism pressure to reflect organizational norms and attitudes toward presenteeism, thus positively predicting employees’ presenteeism behavior (H1). Based on Job Demands-Resources theory (Demerouti et al., 2001), presenteeism pressure may be a job demand that becomes salient in the face of low health resources and is thus expected to negatively associate with job engagement (H2) and OCB (H3), and positively with CWB (H4).

Background
Presenteeism, or attending work despite poor health conditions, threatens employee health and productivity (Demerouti et al., 2009; Luksyte et al., 2015). More research examining why people engage in presenteeism may help mitigate presenteeism behavior and its consequences (Karanika-Murray & Biron, 2020). Past research suggests that personality characteristics (e.g., conscientiousness; Johns, 2011), job insecurity (Johns, 2010), job stress (Demerouti et al., 2009), and low replaceability in one’s job role (Aronsson et al., 2000) often drive presenteeism. A recent qualitative study, however, points to organizational norms and expectations as a crucial ingredient in employee attendance decisions (Ruhle & Süß, 2019) — a possibility that is sorely underexplored. Initial quantitative scale development efforts suggest that organizations may indeed exert pressure on employees to attend work when unwell (i.e., presenteeism pressure; Huang et al., 2019). Still, additional evidence is needed to determine if this organizational driver of presenteeism incrementally predicts work and well-being outcomes over existing constructs.

Methods
Data was collected from working adults (N=561) via Amazon’s MTurk, an online panel service. All Time 1 participants will be invited to complete the second wave of survey data in July and August of 2021 (target N=400-450) to capture lagged associations between presenteeism pressure and expected outcomes three months later. Table 1 summarizes the measures included at each timepoint. Preliminary analysis of Time 1 data tests the incremental validity of presenteeism pressure over presenteeism climate in predicting presenteeism behavior, adjusting for overall organizational wellness culture and individual health complains. Analysis of Time 2 data will allow for similar examination of presenteeism pressure in incrementally predicting participants’ job engagement, OCBs, and CWBs.

Findings
Descriptive statistics and correlations among study variables can be found in Table 2. In support of Hypothesis 1, hierarchical regression analyses conducted using Time 1 data show that presenteeism pressure demonstrates incremental validity above and beyond presenteeism climate in predicting presenteeism behavior. This finding holds true before (see Table 3) and after adjustment for covariates (see Table 4). Moreover, presenteeism pressure predicts presenteeism behavior regardless of whether presenteeism pressure or presenteeism climate is entered first (see Table 4). Corresponding results for the incremental prediction of job engagement, OCBs, and CWBs three months later will be included in the final presentation to test Hypotheses 2-4. Hypothesis 1 will also be retested to determine if presenteeism pressure incrementally predicts presenteeism behavior at Time 2, controlling for Time 1 presenteeism behavior.

Discussion
Organizations may, culturally, push employees to attend work despite poor health. This phenomenon, labelled presenteeism pressure, was found to predict concurrent presenteeism behavior over and above presenteeism climate (i.e., supervisor distrust of absences, coworker competitiveness to work long hours). Follow-up data, which will be available when this research is presented, will clarify if presenteeism pressure predicts other work and well-being outcomes (e.g., job engagement, OCB, CWB). Limitations to the present study include use of an online panel sample and self-report data, though best practices (see Aguinis et al., 2021) were used to proactively address potential issues such as common method variance (e.g., Podsakoff et al., 2003). Notable strengths include the two-wave design, integrated theoretical framework, and practical relevance. We identify presenteeism pressure as a critical organizational driver of presenteeism behaviors. Organizations should use the Presenteeism Pressure Scale to assess employee perceptions that they are expected to attend work even when unwell given that high pressure relates to unhealthy and unproductive presenteeism behaviors.

Conclusions
This study demonstrates that employees can feel pressured by their employing organizations to attend work when they are unwell and that this pressure relates to presenteeism behaviors, above and beyond existing predictors (i.e., organizational presenteeism climate, wellness culture, and employee health complaints). Given growing evidence of the importance of presenteeism pressure for employee health and productivity, future research should examine how organizational policies and the social work context create presenteeism pressure using multilevel analyses. Such work would also better empower organizations to reduce presenteeism pressure and protect employee well-being.

Tags: Applied research, Basic research, Comprehensive Approaches to Healthy Work Design and Well-Being, Emerging Issues, Empirical study, Submission does not consider occupation or industry, Workplace Stress; Outcomes; and Recovery