Supporting Our Frontline Workers With Behavioral Science
Throughout the COVID-19 pandemic, many frontline workers in service positions have suddenly had the spotlight shone on them. Healthcare professionals, transit system operators, waste collectors, and other essential workers have not been able to physically distance or move their work online. Many of their jobs have required them to face the dangers of exposure as they interact with people and materials that carry unknown risks. On top of this, many service workers work rotating shifts. This has been connected to negative health outcomes even outside of pandemics.1,2 The reality for many frontline workers right now is complex and uncertain. However, by leveraging social and agency-based theories of behavioral change, we can provide the people who support us with their own support system.
COVID-19 and shift work
COVID-19 is a novel pandemic, so research on its effects is still emerging. What has been found so far in relation to front-line workers has focused mainly on healthcare professionals. Many of these individuals have reported excessive workloads, unreasonable hours, inadequate social support, and inadequate personal protective equipment (such as masks and gowns), all in addition to increased risk of COVID-19 exposure.3 These outcomes have been associated with increased stress, anxiety, depressive symptoms, insomnia, and development of trauma, all of which negatively impact health and productivity.
A significant number of these healthcare professionals work shifts. Due to their rotating schedules, these workers experience more disruption to their biological systems than workers who have regular daily schedules. Sleep and diet are two prime examples. Disruptions to these systems can drive changes in the body that lead to the development of diseases such as stroke, coronary heart disease, certain cancers, and type two diabetes.1,9 The health of frontline workers, even beyond the scope of the pandemic, is clearly an issue that needs attention. While COVID-19 has disrupted all of our lives in different ways, its effects have interacted with pre-existing difficulties that are structural.
Supportive interventions
There are components of people’s health that depend on the environment around them. This is where leveraging behavioral science can make a great impact.
Interventions can take on a number of forms. There has been some success with those that take into account frontline workers’ hierarchy of needs.4 Maslow’s hierarchy of needs is a framework that posits that human health depends on satisfying physiological and psychological needs in a specific order. A General Theory of Behavior, recently updated by Dr. David Marks in 2018, has explained this hierarchy in terms of physiological and psychological balance.4 Workers will constantly be preoccupied by their need to regain balance when their sleep and diet schedules are disrupted, contributing to psychological problems such as stress if left unsatisfied. According to Maslow’s hierarchy, physical needs such as sleep and nutrition need to be satisfied first.
References
- Potter, G.D.M. & Wood, T.R. (2020). The future of shift work: Circadian biology meets personalised medicine and behavioural science. Frontiers in Nutrition, 7.
- Hayes, S.C., Hofmann, S.G., & Stanton, C.E. (2020). Process-based functional analysis can help behavioral science, step up to novel challenges: COVID-19 as an example. Journal of Contextual Behavioral Science.
- Spoorthy, M. S., Pratapa, S. K., & Mahant, S. (2020). Mental health problems faced by healthcare workers due to the COVID-19 pandemic – A review. Asian Journal of Psychiatry, 51.
- Zaka, A., Shamloo, S.E., Florente, P., & Tafuri, A. (2020). COVID-19 pandemic as a watershed moment: A call for systematic psychological health care for frontline medical staff. Journal of Health Psychology, 25(7), 883-887.
- Kecklund, G., & Axelsson, J. (2016). Health consequences of shift work and insufficient sleep. Bmj, 355(i5210).
- Kelly, M.P., Barker, M. (2016). Why is changing health-related behaviour so difficult? Public Health, 126. 109-116.
- Madsen, T.E., Dobiesz, V., Das, D., Sethuraman, K., Agrawal, P., Zeidan, A., Goldberg, E., Safdar, B., & Lall, M.D. (2020). Unique risks and solutions for equitable advancement during the Covid-19 pandemic: Early experience from frontline physicians in academic medicine. NEJM Catalyst: Innovations in Care Delivery, 1(4).
- Lillehoj, C. J., Nothwehr, F., Shipley, K., & Voss, C. (2015). Vending assessment and program implementation in four Iowa worksites. Health Promotion Practice, 16(6), 814-825.
- Bucher, T., Collins, C., Rollo, M. E., McCaffrey, T. A., De Vlieger, N., Van der Bend, D., … & Perez-Cueto, F. J. (2016). Nudging consumers towards healthier choices: a systematic review of positional influences on food choice. British Journal of Nutrition, 115(12), 2252-2263.
- Zhao, J., Freeman, B., & Li, M. (2016). Can mobile apps influence people’s health behavior change? An evidence review. Journal of Medical Internet Research, 18(11).
- Grant, A.M. & Hofmann, D.A. (2011). It’s not all about me: Motivating hand hygiene among health care professionals by focusing on patients. Psychological Science, 22(12), 1494-1499.
About the Author
Neir Mazur
Neir approaches research with an interdisciplinary focus, connecting research from many different domains of knowledge to form new ideas. As a social science researcher, their interests lie primarily in societal health, policy, and education. How research can inform policy and practice is a question that drives their writing and reflection. Over the past several years, Neir has focused on themes of equity and how cultural identity and cognitive research interact. Neir holds a Master of Arts in Education and a Bachelor of Cognitive Science, from the University of Toronto and Carleton University respectively.
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I was blown away with their application and translation of behavioral science into practice. They took a very complex ecosystem and created a series of interventions using an innovative mix of the latest research and creative client co-creation. I was so impressed at the final product they created, which was hugely comprehensive despite the large scope of the client being of the world's most far-reaching and best known consumer brands. I'm excited to see what we can create together in the future.
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