Search

Statistical profiling algorithms claiming to predict which jobseekers are at risk of becoming long‐term unemployed are spread unevenly across countries. However, the pathways and histories of these tools are understudied. Because the profiling path in France is a winding one, it is fruitful to study the production of profiling acceptability within the Public Employment Service (PES), and upstream of its reception by frontline advisers. Using a mix of interviews and written sources, we show that the production of profiling acceptability sits at the crossroads of two processes: technical and political transformations of the instrument itself and broader institutional and managerial transformations of the PES. On the basis of this case study, the paper enriches our understanding of the slow and incremental rationalization of public services that we have termed "professional rationalization." We argue that, far from being a softened or moderated form of bureaucratic rationalization, it is powerful—perhaps even irreversible—precisely because it transforms its target (frontline advisers) before the rationalization instrument is even deployed. [ABSTRACT FROM AUTHOR]

Background: Frontline staff in psychiatry need to perform at a very high professional level in order to ensure patient and community safety. At the same time they are exposed to high levels of stress and workplace trauma. This may have severe consequences for their professional quality of life. In addition, health care workers in general have higher incidence levels of childhood adversity than the general population. The CRITIC (CRITical Incidents and aggression in Caregivers) Study aims to improve increased understanding of the interaction between personal life history (childhood adversity and benevolence), individual capabilities, exposure to trauma and violence at work and Professional Quality of Life (ProQOL). Method: The Critic Study is a cross-sectional survey of these aspects in frontline, treatment and administrative staff in clinical and forensic psychiatry. We aim to include 360 participants. Participants will be asked to complete questionnaires on childhood adversity and childhood benevolence (assessing personal life history), professional quality of life, current trauma and violence exposure, current mental health (depression, anxiety and stress), coping, social support, work engagement and resilience. In this study we will examine the moderating role of adverse and benevolent childhood experiences in the association between workplace trauma exposure and professional quality of life. Finally, a theoretical model on the relationships between trauma, stress and coping in the context of professional functioning will be tested using structural equation modelling. Discussion: The CRITIC study examines which factors influence the complex relationship between childhood adversity and benevolence, and ProQOL in healthcare workers. It also aims to provide insight into the complex relationship between personal life history, individual characteristics, exposure to trauma and violence at work and ProQOL. The results can be used for designing interventions to increase resilience to trauma and to improve professional quality of life among health care professionals. [ABSTRACT FROM AUTHOR]

BackgroundFrontline staff in psychiatry need to perform at a very high professional level in order to ensure patient and community safety. At the same time they are exposed to high levels of stress and workplace trauma. This may have severe consequences for their professional quality of life. In addition, health care workers in general have higher incidence levels of childhood adversity than the general population. The CRITIC (CRITical Incidents and aggression in Caregivers) Study aims to improve increased understanding of the interaction between personal life history (childhood adversity and benevolence), individual capabilities, exposure to trauma and violence at work and Professional Quality of Life (ProQOL).MethodThe Critic Study is a cross-sectional survey of these aspects in frontline, treatment and administrative staff in clinical and forensic psychiatry. We aim to include 360 participants. Participants will be asked to complete questionnaires on childhood adversity and childhood benevolence (assessing personal life history), professional quality of life, current trauma and violence exposure, current mental health (depression, anxiety and stress), coping, social support, work engagement and resilience. In this study we will examine the moderating role of adverse and benevolent childhood experiences in the association between workplace trauma exposure and professional quality of life. Finally, a theoretical model on the relationships between trauma, stress and coping in the context of professional functioning will be tested using structural equation modelling.DiscussionThe CRITIC study examines which factors influence the complex relationship between childhood adversity and benevolence, and ProQOL in healthcare workers. It also aims to provide insight into the complex relationship between personal life history, individual characteristics, exposure to trauma and violence at work and ProQOL. The results can be used for designing interventions to increase resilience to trauma and to improve professional quality of life among health care professionals.Trial registrationThe CRITIC study has been approved by the Medical Ethical Committee of the Erasmus Medical Centre, under trial registration number NL73417.078.20

Emergency departments (EDs) serve as the front line when patients encounter the hospital system. Limited data are available of patients' alcohol habits collected during Danish ED visits, and no studies have, to our knowledge, examined frontline staffs' (registered nurses and medical secretaries) acceptability to deliver anonymous alcohol surveys to patients. We aimed at examining the proportion of survey respondents and the prevalence of patients' alcohol habits and also exploring frontline staff acceptability of the distribution of an anonymous survey regarding patients' alcohol habits in EDs. Intendedly, all eligible patients ≥18 years old entering two EDs in March 2019 should receive a survey based on the Alcohol Use Disorder Identification Test. The study was an explanatory, sequential, mixed methods design, and results were analyzed with descriptive statistics and a deductive content analysis based on the theoretical framework of acceptability. In total, 15% (n = 1,305) of the total 8,679 patients in the EDs returned the survey. Qualitative analysis of interviews (n = 31) with staff showed that they had been reluctant to distribute the survey primarily because of ethical concerns of anonymity, freedom of choice, and being nonjudgmental toward patients. Hence, patients with no obvious alcohol problems were more likely to receive the survey. Still, we found that 23% of the respondents had an Alcohol Use Disorder Identification Test score ≥ 8. Results indicate that frontline staffs' recognition of patients' alcohol use is inadequate, and findings show a low degree of acceptability among staff to deliver an anonymous survey, which is in line with earlier described barriers toward screening activities in EDs. [ABSTRACT FROM AUTHOR]

Background: Increased workload, lack of resources, fear of infection, and the suffering and loss of residents have placed a significant emotional burden on regulated and unregulated direct care nursing staff (eg, registered nurses, licensed practical nurses, and care aides) in nursing homes (residential long-term care homes). Psychological distress and burnout related to COVID-19 have been cited among direct care staff within nursing homes. Studies have also emphasized the resilience of direct care staff, who, despite the significant challenges created by the pandemic, remained committed to providing quality care. To date, only one nursing home-specific review has synthesized evidence from 15 studies conducted early in the pandemic, which reported anxiety, posttraumatic stress disorder, and depression among direct care staff. Objective: The objectives of this systematic review are to (1) synthesize all empirical evidence on the impact of the COVID-19 pandemic on direct care staffs' mental health, physical health, and work-life outcomes; (2) identify specific risks and protective factors; and (3) examine the effect of strategies or interventions that have been developed to improve these outcomes. Methods: We will include all study designs reporting objective or subjective measurements of direct care staffs' mental health, physical health, and quality of work-life in nursing home settings during the COVID-19 pandemic (January 2020 onward). We will search multiple databases (MEDLINE, CINAHL, Embase, Scopus, and PsycINFO) and gray literature sources with no language restrictions. Two authors will independently screen, assess data quality, and extract data for synthesis. Given the heterogeneity in research designs, we will use multiple data synthesis methods that are suitable for quantitative and qualitative studies. Results: As of December 2022, full text screening has been completed and data extraction is underway. The expected completion date is June 30, 2023. Conclusions: This systematic review will uncover gaps in current knowledge, increase our understanding of the disparate findings to date, identify risks and factors that protect against the sustained effects of the pandemic, and elucidate the feasibility and effects of interventions to support the mental health, physical health, and quality of work-life of frontline nursing staff. This study will inform future research exploring how the health care system can be more proactive in improving quality of work-life and supporting the health and psychological needs of frontline staff amid extreme stressors such as the pandemic and within the wider context of prepandemic conditions. [ABSTRACT FROM AUTHOR]

This paper considers the link between policy tools and governance modes – the characteristic ways frontline staff are meta-governed. It asks: Are substantive policy tools coupled to procedural tools (governance modes) that can guide local service delivery agencies and the work of individuals delivering welfare services? The substantive policy tools in this case are those typically utilised to reform welfare-to-work services: contracting-out of services and competitive tendering, and the regulation of quasi-markets. These are hypothesised to flow through to procedural policy tools in the form of corporate and market incentives and regulatory (bureaucratic) methods that shape how work is done (governance modes), privileging certain practice orientations at the frontline. Policy makers seek to shape these meta-level governance modes because they should result in systemic change, based on a reconfiguration of policy actors and their interrelationships, for both service delivery agencies and the individuals working in them. We identified four ideal-type governance modes (bureaucratic, corporate, market and network) and tracked which of these were dominant in-practice at the frontline in Australia and the UK at two levels: office and personal, at four points in time (1998, 2008, 2012 and 2016). We found that the dominant mode of organisation at the office level was corporate, followed by bureaucratic in both nations. But the bureaucratic mode had grown in strength over time, particularly in Australia, and as a personal priority for staff, as re-regulation occurred. The results indicate a coupling between substantive policy tools and governance modes at the frontline of welfare-to-work.

Abstract Background Theory-based implementation strategies, such as audit and feedback (A&F), can improve the adoption of evidence-based practices. However, few strategies have been developed and tested to meet the needs of specialty clinics. In particular, frontline staff can execute cardiovascular disease (CVD) risk reduction protocols, but A&F strategies to support them are not well examined. Our objective was to develop and evaluate a theory-based approach to A&F, Interactive and Participatory A&F (IPAF). Methods We developed IPAF informed by two complementary theories, self-regulation theory (SRT) and self-determination theory (SDT). IPAF applies concepts from these theories to inform (1) what to address with staff to improve rates of best practices (SRT) and (2) how to interact with staff to improve behaviors aligned with best practices (SDT). We promoted IPAF fidelity by developing a semi-structured guide to facilitate staff discussion of target behaviors, perceived barriers, goals, and action plans. We evaluated IPAF in the context of eight quasi-experimental implementations in specialty clinics across two health systems. Following a hybrid type 2 effectiveness-implementation design, we reported intervention outcomes for CVD risk reduction elsewhere. This paper reports implementation outcomes associated with IPAF, focusing on feasibility, appropriateness, acceptability, fidelity, and adoption. We evaluated implementation outcomes using mixed-methods data including electronic health record (EHR) data, team records, and staff questionnaire responses. Results Eighteen staff participated in 99 monthly, individual, synchronous (face-to-face or phone) IPAF sessions during the first 6 months of implementation. Subsequently, we provided over 375 monthly feedback emails. Feasibility data revealed high staff attendance (90–93%) and engagement in IPAF sessions. Staff highly rated questionnaire items about IPAF acceptability. Team records and staff responses demonstrated fidelity of IPAF delivery and receipt. Adoption of target behaviors increased significantly (all P values < 0.05), and adoption or behaviors were maintained for over 24 months. Conclusions We developed and evaluated a theory-based approach to A&F with frontline staff in specialty clinics to improve the implementation of evidence-based interventions. The findings support feasibility, appropriateness, acceptability, and fidelity of IPAF, and staff adoption and maintenance of target behaviors. By evaluating multi-site implementation outcomes, we extended prior research on clinic protocols and A&F beyond primary care settings and providers.

Introduction Anxiety has become a topical issue since the arrival of the coronavirus pandemic, especially for frontline healthcare professionals as they deal with patients affected by the Covid-19. Objectives Objectify anxiety in frontline medical and paramedical staff and study its associated factors. Methods We conducted a national descriptive and analytical cross-sectional study via a survey over a 2-month period from September to October 2020. We used “Beck Anxiety Inventory” to screen anxiety as well as “Brief Cope Scale” to detect probable correlations between anxiety and coping mechanisms. Results We collected 78 persons. The mean age was 29.86 years. 35.9% moved out of home. 39.7% worked in Covid units. 7.7% had personal psychiatric history. 76.9% provided direct care to patients with Coronavirus. The frontline staff reported that only 29.5% of patients were stables. Only 48.4% received adequate training of protection against Covid-19. 64.1% of professionals did PCR test and only 16.7% of them tested positive. We objectified an increase of 6.4% in the anxiolytics use. Stigma affected 57.7% of professionals. We highlighted a link between anxiety and social support strategy (p=0.048). 92.3 % of the staff suffered from anxiety according to Beck Anxiety Inventory. Conclusions Screening anxiety among frontline medical and paramedical staff might enhance their productivty and thus provide patients with the best care. Disclosure No significant relationships.

Introduction The current coronavirus pandemic is a unique and unusual situation. It is putting the general population under severe strain. However, frontline medical and paramedical staff remain particularly vulnerable to depression because of its close contact with patients. Objectives The aim of this work was to screen and evaluate depression in the frontline professionals during the pandemic and to study their associated factors . Methods In this study , we conducted a national descriptive and analytical cross-sectional study over a 2-month period from September to October 2020. We used “Beck Depression Inventory” to assess depression and “Brief Cope Scale” to detect a possible correlation between depression and coping mechanisms. Results We collected 78 professionals. The mean age was 29.86 years. 2/3 of workers were women. 67.9% of the staff were residents. 39.7% worked in Covid units. 7.7% had personal psychiatric history. 56.4% of the staff worked daily and 76.9% of them provided direct care to patients with Coronavirus. 52.6% of workers did not receive adequate training of protection against Covid-19.The staff reported 66.7% of death among their patients. 42.3% suffered from minor depression and only 2.3% suffered from severe depression. During this period we objectified an increase of 14.1% in the psychoactive substances use. Stigma affected 57.7% of professionals. We didn’t objectify a significant correlation between Depression and coping mechanisms . Conclusions Screening depression among healthcare professionals should be considered in order to prevent it, ensure continuity of care and avoid sick leaves. Disclosure No significant relationships.

Background: In China, mental health of frontline medical staff might be influenced by clinicians' ability to handle the outbreak of coronavirus disease 2019 (COVID-19). Few studies to-date have addressed the association between clinicians' competencies and mental health in this context. This cross-sectional study was to examine the prevalence of mental health symptoms among frontline medical staff that fought against the COVID-19 outbreak, and explore the associations between their competencies, and separate and concurrent depressive and anxiety symptoms. Methods: A total of 623 frontline medical staff was included in this study. Competencies, depressive symptoms, and anxiety symptoms were assessed using a self-reported short form of the Chinese clinical physicians' competency model, Patient Health Questionnaire-9, and Generalized Anxiety Disorder-7 questionnaire, respectively. Logistic regression models were used to evaluate the associations between one SD increase in competency scores and the prevalence of mental health problems. Results: The prevalence of depressive, anxiety, and comorbid depressive and anxiety symptoms was 40.93, 31.78, and 26.00%, respectively. Among the medical staff with higher total competency scores, the prevalence of depressive [odds ratios (ORs) = 0.67, 95% confidence intervals (CIs): 0.55–0.81], anxiety (OR = 0.68, 95% CI: 0.56–0.83), and comorbid anxiety and depressive symptoms (OR = 0.69, 95% CI: 0.55–0.83) was lower than among their lower-scoring counterparts. Subgroup analyses stratified by core competency scores revealed similar associations as the main analyses. Conclusion: The present findings highlight the association between high core competency scores and lower prevalence of depressive, anxiety, and comorbid anxiety and depressive symptoms. [ABSTRACT FROM AUTHOR]

BackgroundIn China, mental health of frontline medical staff might be influenced by clinicians' ability to handle the outbreak of coronavirus disease 2019 (COVID-19). Few studies to-date have addressed the association between clinicians' competencies and mental health in this context. This cross-sectional study was to examine the prevalence of mental health symptoms among frontline medical staff that fought against the COVID-19 outbreak, and explore the associations between their competencies, and separate and concurrent depressive and anxiety symptoms.MethodsA total of 623 frontline medical staff was included in this study. Competencies, depressive symptoms, and anxiety symptoms were assessed using a self-reported short form of the Chinese clinical physicians' competency model, Patient Health Questionnaire-9, and Generalized Anxiety Disorder-7 questionnaire, respectively. Logistic regression models were used to evaluate the associations between one SD increase in competency scores and the prevalence of mental health problems.ResultsThe prevalence of depressive, anxiety, and comorbid depressive and anxiety symptoms was 40.93, 31.78, and 26.00%, respectively. Among the medical staff with higher total competency scores, the prevalence of depressive [odds ratios (ORs) = 0.67, 95% confidence intervals (CIs): 0.55–0.81], anxiety (OR = 0.68, 95% CI: 0.56–0.83), and comorbid anxiety and depressive symptoms (OR = 0.69, 95% CI: 0.55–0.83) was lower than among their lower-scoring counterparts. Subgroup analyses stratified by core competency scores revealed similar associations as the main analyses.ConclusionThe present findings highlight the association between high core competency scores and lower prevalence of depressive, anxiety, and comorbid anxiety and depressive symptoms.

Promoted by marketing discourses, customer sovereignty is characterized by the cult of the customer and the belief that contact staff have to serve the customer. However, research shows that customers adopt improper conduct, such as fraudulent or aggressive behaviors. While largely tolerated, these behaviors prove damaging for contact staff and could eventually lead them to react. How do frontline actors react to such behaviors, which prevent them from developing customer relations in accordance with the mythical discourse? This is the question our article explores. To do so, we use Becker's interactionism approach to deviance, and investigate how frontline actors in five organizations deal with customer complaints they consider as 'deviant'. Our results show that when faced with behaviors that they no longer wish to tolerate, contact staff educate, amateurize, or penalize the customer. This research contributes by conceptualizing three alternative forms of relations to customer sovereignty, which contact staff attempt to legitimize through internal and external resources. [ABSTRACT FROM AUTHOR]

Background: The coronavirus disease 2019 (COVID-19) is spreading globally, and it is significant to pay attention to the mental health of frontline staff in this pandemic. This study is aimed to explore the sex difference among the frontline staff in demographics, characteristics of mental state, and the potential relationship between them. Method: A total of 2,614 Chinese frontline staff were recruited. The Self-Rating Anxiety Scale (SAS) and the Patient Health Questionnaire-9 (PHQ-9) were used for assessing the mental status of frontline staff, and the Fatigue Self-Assessment Scale (FSAS) was used for detecting fatigue. Result: The prevalence rate of anxiety for female frontline staff is higher than that of male (P = 0.003), and the prevalence rate of depression is similar between them (P = 0.091). After comparing the risk factors of unhealthy mental state between different sexes, it is found that family income below 100,000 [depression: odds ratio (OR) 1.37; 95% CI, 1.08–1.73; anxiety: OR 1.99; 95% CI, 1.44–2.75], unsupported of family (depression: OR 10.94; 95% CI, 1.39–85.79; anxiety: OR 11.92; 95% CI, 3.80–37.36), and marriage (depression: OR 1.67; 95% CI, 1.15–2.43) are risk factors for male, and total fatigue (depression: OR 2.96; 95% CI, 1.46–6.02) is risk factor for female. Conclusions: This study found that depression and anxiety are widespread among the frontline staff of COVID-19, and anxiety showed a higher prevalence rate among female frontline staff. From the sex difference in risk factors, the focus of psychological interventions may differ between genders. Men with low family income, unsupported by family or marriage, and women with a high score of total fatigue required particular attention to their psychological status. [ABSTRACT FROM AUTHOR]

This paper considers the link between policy tools and governance modes – the characteristic ways frontline staff are meta-governed. It asks: Are substantive policy tools coupled to procedural tools (governance modes) that can guide local service delivery agencies and the work of individuals delivering welfare services? The substantive policy tools in this case are those typically utilised to reform welfare-to-work services: contracting-out of services and competitive tendering, and the regulation of quasi-markets. These are hypothesised to flow through to procedural policy tools in the form of corporate and market incentives and regulatory (bureaucratic) methods that shape how work is done (governance modes), privileging certain practice orientations at the frontline. Policy makers seek to shape these meta-level governance modes because they should result in systemic change, based on a reconfiguration of policy actors and their interrelationships, for both service delivery agencies and the individuals working in them. We identified four ideal-type governance modes (bureaucratic, corporate, market and network) and tracked which of these were dominant in-practice at the frontline in Australia and the UK at two levels: office and personal, at four points in time (1998, 2008, 2012 and 2016). We found that the dominant mode of organisation at the office level was corporate, followed by bureaucratic in both nations. But the bureaucratic mode had grown in strength over time, particularly in Australia, and as a personal priority for staff, as re-regulation occurred. The results indicate a coupling between substantive policy tools and governance modes at the frontline of welfare-to-work. [ABSTRACT FROM AUTHOR]

Background: The coronavirus disease 2019 (COVID-19) is spreading globally, and it is significant to pay attention to the mental health of frontline staff in this pandemic. This study is aimed to explore the sex difference among the frontline staff in demographics, characteristics of mental state, and the potential relationship between them.Method: A total of 2,614 Chinese frontline staff were recruited. The Self-Rating Anxiety Scale (SAS) and the Patient Health Questionnaire-9 (PHQ-9) were used for assessing the mental status of frontline staff, and the Fatigue Self-Assessment Scale (FSAS) was used for detecting fatigue.Result: The prevalence rate of anxiety for female frontline staff is higher than that of male (P = 0.003), and the prevalence rate of depression is similar between them (P = 0.091). After comparing the risk factors of unhealthy mental state between different sexes, it is found that family income below 100,000 [depression: odds ratio (OR) 1.37; 95% CI, 1.08–1.73; anxiety: OR 1.99; 95% CI, 1.44–2.75], unsupported of family (depression: OR 10.94; 95% CI, 1.39–85.79; anxiety: OR 11.92; 95% CI, 3.80–37.36), and marriage (depression: OR 1.67; 95% CI, 1.15–2.43) are risk factors for male, and total fatigue (depression: OR 2.96; 95% CI, 1.46–6.02) is risk factor for female.Conclusions: This study found that depression and anxiety are widespread among the frontline staff of COVID-19, and anxiety showed a higher prevalence rate among female frontline staff. From the sex difference in risk factors, the focus of psychological interventions may differ between genders. Men with low family income, unsupported by family or marriage, and women with a high score of total fatigue required particular attention to their psychological status.

OBJECTIVE To obtain feedback regarding the Safewards program from frontline staff on an inpatient forensic unit, in order to determine their opinions if the program was effective, and how the program could be improved. STUDY DESIGN Qualitative study design. PLACE AND DURATION OF THE STUDY The study was carried out at Forensic Psychiatric Unit in Canada, during a period of three months (1st January 2020 to 31st March 2020). SUBJECTS AND METHODS All psychiatric nurses and other frontline staff on the Forensic unit of a psychiatric hospital were invited to participate in a voluntary, anonymous, semi-structured interview with a research student. RESULTS The majority of staff expressed that Safewards is an effective and useful program that was worth the time it took to implement, and expressed some suggestions for improvement. CONCLUSION More experienced staff are more likely to feel that the program is unnecessary, and newer staff are more likely to feel that they lack sufficient training. [ABSTRACT FROM AUTHOR]

Background: Children with chronic physical health conditions are up to six times more likely to develop a mental health condition than their physically well peers. Frontline pediatric hospital staff are in a good position to identify mental health problems and facilitate appropriate support for patients. To date, no evaluation of mental health literacy training has taken place with this professional group to enable early identification of difficulties. It is also not known whether face-to-face or digital training is more effective or preferable in this setting. To improve the skills of frontline hospital staff, a face-to-face and digital mental health literacy training course was delivered using MindEd content and evaluated in a randomized controlled trial.Method: Two-hundred and three frontline staff across different professions from a tertiary pediatric hospital were randomized to a face-to-face (n = 64), digital (n = 71), or waitlist control group (n = 68). Face-to-face training was two and a half hours and digital training took ~1 h. The effects of training were evaluated pre- and post-training and at two-week follow-up. Questionnaires assessed mental health knowledge, stigma, confidence in recognizing concerns and knowing what to do, actual helping behavior, as well as training delivery preference, completion rate, and satisfaction.Results: Both face-to-face and digital training increased mental health knowledge, confidence in recognizing mental health problems and knowing what to do compared to waitlist controls. Digital training increased actual helping behavior relative to the waitlist controls and stigma decreased across all groups. Staff were satisfied with both delivery methods but preferred face-to-face training.Conclusions: The results provide promising findings that digital content is an effective way of improving mental health literacy in frontline pediatric hospital staff. Providing digital training could be a time-efficient way of upskilling non-mental health professionals to identify mental health needs in a pediatric population and facilitate access to appropriate care.

Despite assurance measures being developed alongside expanding scopes of practice, poor NHS ambulance staff wellbeing means high-quality job performance and patient care are not guaranteed. The UK's service is struggling to cope with growing demand and is not fully adapting from its historical emergency response role to meet modern-day urgent care needs. This puts unnecessary pressures and risks of stress from exhausting, intense work on to its most valuable resource: staff. Detrimental workplace cultures exacerbate this, along with added target-driven strain from non-evidence-based ambulance quality indicators. With poor support, communication, leadership and mental wellbeing provision, staff are increasingly dissatisfied, demoralised and experiencing a myriad of health problems. Consequences include excessive staff sickness absences and turnover as well as an up to 75% higher suicide risk. Trusts should collaborate to identify and address the causes of demand that cannot be met, and chief executives and boards should work with staff to prioritise structured wellbeing assessment and improvement. Further research is also needed. [ABSTRACT FROM AUTHOR]

Background: Children with chronic physical health conditions are up to six times more likely to develop a mental health condition than their physically well peers. Frontline pediatric hospital staff are in a good position to identify mental health problems and facilitate appropriate support for patients. To date, no evaluation of mental health literacy training has taken place with this professional group to enable early identification of difficulties. It is also not known whether face-to-face or digital training is more effective or preferable in this setting. To improve the skills of frontline hospital staff, a face-to-face and digital mental health literacy training course was delivered using MindEd content and evaluated in a randomized controlled trial. Method: Two-hundred and three frontline staff across different professions from a tertiary pediatric hospital were randomized to a face-to-face (n = 64), digital (n = 71), or waitlist control group (n = 68). Face-to-face training was two and a half hours and digital training took ~1 h. The effects of training were evaluated pre- and post-training and at two-week follow-up. Questionnaires assessed mental health knowledge, stigma, confidence in recognizing concerns and knowing what to do, actual helping behavior, as well as training delivery preference, completion rate, and satisfaction. Results: Both face-to-face and digital training increased mental health knowledge, confidence in recognizing mental health problems and knowing what to do compared to waitlist controls. Digital training increased actual helping behavior relative to the waitlist controls and stigma decreased across all groups. Staff were satisfied with both delivery methods but preferred face-to-face training. Conclusions: The results provide promising findings that digital content is an effective way of improving mental health literacy in frontline pediatric hospital staff. Providing digital training could be a time-efficient way of upskilling non-mental health professionals to identify mental health needs in a pediatric population and facilitate access to appropriate care. [ABSTRACT FROM AUTHOR]

'Samskabelse' er i de senere år blevet en strategisk tilgang for kommuner, som ønsker grøn omstilling i løsningen af opgaver i forbindelse med forsyning, affaldshåndtering osv. Samskabelse ses som et værktøj til at skabe adfærdsændringer hos borgerne samt en forstærket involvering af borgerne i det lokale demokrati. Samskabelsesstrategien kan imidlertid forekomme modsætningsfyldt: Borgerne skal frivilligt samarbejde med offentlige myndigheder om at udforme initiativer til ændret adfærd på områder, hvor borgerne almindeligvis oplever, at de har autonomi. Dette modsætningsfyldte forhold gør opgaven til en udfordring for frontpersonalet, som står med borgerkontakten. Artiklen præsenterer analyser af kommunikationen i et skandinavisk EU-finansieret projekt om 'samskabende grøn omstilling' (SGO), hvor kommunalt frontpersonale i fire tilfælde (to i Danmark og to i Sverige) har arbejdet med samskabelse i deres lokalområde for at udvikle en fælles samskabelsesmetode til grøn omstilling. Vi har som klimakommunikationsforskere fulgt projektet og undervejs samarbejdet med frontpersonalet om metodeudviklingen. Vores analyse af deltagernes kommunikation viser, at kompetence til at lytte til borgerne samt tid til kollegial erfaringsudveksling er afgørende for frontpersonalets udvikling af kompetence til samskabelse. Derfor konkluderer vi, at såvel det politiske som det ledelsesmæssige niveau i kommunerne bør tilgodese disse elementer, når man vælger en samskabelsesstrategi i forbindelse med påvirkning af borgernes adfærd i forhold til den grønne omstilling. [ABSTRACT FROM AUTHOR]

Context: The Rural Adversity Mental Health Program (RAMHP) connects people who need mental health assistance in rural and remote New South Wales (NSW), Australia with appropriate services and resources. In 2016, RAMHP underwent a comprehensive reorientation to meet new state and federal priorities. A full assessment of program data collection methods for management, monitoring and evaluation was undertaken. Reliable data were needed to ensure program fidelity and to assess program performance. Issues: The review indicated that existing data collection methods provided limited and unreliable information, were inconvenient for RAMHP coordinators to use and unsuited to their itinerant role. A mobile collection tool (app) was developed to address RAMHP activity data needs. A design and implementation process was followed to optimise data collection and to ensure the successful use of the app by coordinators. Lessons learned: The early planning investment was worthwhile, the app was successfully adopted by the coordinators and a much improved data collection capability was achieved. Moreover, data capture increased, while errors decreased. Data are more reliable, specific, timely and informative and are used for strategic and operational planning and to demonstrate program performance.

Implementing a planned change successfully is critical to organizations' performance and depends on all members' participation. Most research has studied leaders' and middle managers' role in planning and communicating change, not how frontline staff – those who deal directly with clients and customers, and their direct managers – ultimately implement it. This is surprising, especially in professionalized organizations, as involvement of frontline managers and professional staff is critically important to achieving change. This article reports on a comparative case study that examined how and why some acute care hospital units were more successful in implementing planned change. The data analysis identified change-facilitating and change-inhibiting microdynamics (activities and interactions) among frontline teams: managers and professional nursing staff at the hospital units, which resulted in more and less efficacious implementation of planned change and virtuous and vicious change cycles. The authors developed models that show how and why microdynamics differed in the units and offer guidance to managers in encouraging planned change at organizations' front line. [ABSTRACT FROM AUTHOR]

Objective: To conduct a survey of the training experiences and needs of paraprofessionals (frontline staff) serving adults with moderate–severe TBI from the perspectives of four stakeholder groups: paraprofessionals, professionals, adults living with brain injury, and family members. Participants: Participants were (a) 28 paraprofessionals, (b) 45 professionals, (c) 41 adults living with brain injury, and (d) 22 family members, for a total of 136 participants. Design: We conducted an online, nationwide survey containing closed and open-ended questions. Four different versions of the survey were developed, one for each of the stakeholder groups, to capture their unique perspectives on the topic of paraprofessional training. Results: Descriptive statistics, non-parametric statistics, and qualitative, comment-based information across the four groups revealed that (a) paraprofessionals require comprehensive training to address the complex needs of persons with brain injury; (b) a range of training options and modalities is preferred; and (c) there are several challenges associated with providing paraprofessional training. Conclusions: This survey highlights the need for a comprehensive range of paraprofessional training options that address both knowledge and skill acquisition. These data have informed the development of an online, interactive training program for paraprofessionals serving this population. [ABSTRACT FROM AUTHOR]

Context: The Rural Adversity Mental Health Program (RAMHP) connects people who need mental health assistance in rural and remote New South Wales (NSW), Australia with appropriate services and resources. In 2016, RAMHP underwent a comprehensive reorientation to meet new state and federal priorities. A full assessment of program data collection methods for management, monitoring and evaluation was undertaken. Reliable data were needed to ensure program fidelity and to assess program performance. Issues: The review indicated that existing data collection methods provided limited and unreliable information, were inconvenient for RAMHP coordinators to use and unsuited to their itinerant role. A mobile collection tool (app) was developed to address RAMHP activity data needs. A design and implementation process was followed to optimise data collection and to ensure the successful use of the app by coordinators. Lessons learned: The early planning investment was worthwhile, the app was successfully adopted by the coordinators and a much improved data collection capability was achieved. Moreover, data capture increased, while errors decreased. Data are more reliable, specific, timely and informative and are used for strategic and operational planning and to demonstrate program performance. [ABSTRACT FROM AUTHOR]

Context: The Rural Adversity Mental Health Program (RAMHP) was founded in 2007 with the specific focus of responding to drought-related mental health needs among farmers in rural and remote New South Wales (NSW), Australia. Successive re-funding enabled the program to evolve strategically and increase its reach. Over a decade, the program’s focus has expanded to include all people in rural and remote NSW in need of mental health assistance, and not just in times of adversity such as drought. Issue: The program’s longest re-funding period, 2016–2020, provided the opportunity for a comprehensive review and longer term planning. Several priorities influencing program renewal were evident at this time: the need to improve data collection and evaluation methods, a reassessment of the program’s primary focus and the need to align with significant government mental health reforms. A program logic model (PLM) was developed, in collaboration with frontline RAMHP coordinators, to steer reorientation, clarify objectives, activities and outcomes, and improve data collection. A PLM is a graphic depiction of a program, showing the rationale of how inputs and activities lead to outcomes. Lessons learned: Four key lessons were identified. (1) The development of the PLM in collaboration with the RAMHP coordinators (frontline staff) was found to be an important vehicle for ensuring their acceptance and adoption of strategic changes. (2) The collaborative development process also provided the opportunity to decide upon consistent terminology to describe the program, facilitating communication of the value of RAMHP to external stakeholders. (3) The PLM enabled a clear but flexible program structure that aligned with changes in the mental health system to be described. (4) The PLM provided the foundation for the development of an evaluation framework, including a mobile app, to aid data collection to underpin accountability. Investing in the development of a PLM early in program reorientation provided many benefits for RAMHP, including improved role clarity and communication, staff commitment to program changes and a foundation for comprehensive program evaluation that integrates with program planning. The PLM proved a key foundational tool to reorient RAMHP by producing a clear program structure that was agreed upon by all staff. [ABSTRACT FROM AUTHOR]

Work with clients who have trauma-related problems is reported to lead to a constellation of reactions including vicarious traumatization, compassion fatigue, and burnout. Traumatic experiences are ubiquitous in the lives of homeless people, stemming from multiple life events prior to, and as a result of, experiencing homelessness. While most studies examine either burnout and vicarious traumatization or potential PTSD in people who work with those who are traumatized, they generally do not look at the possible co-existence of all three factors. They also do not explore if these factors indicate the extent to which burnout or vicarious traumatization may lead to PTSD symptoms or that the existence of PTSD symptoms may precipitate greater rates of burnout. In addition, there are no existing studies that provide a quantitative view of the characteristics of frontline workers in homeless services. In this study, we surveyed 472 individuals who work in frontline positions in homeless shelters in 23 different organizations. We found rates of burnout, vicarious traumatization and compassion satisfaction, comparable to workers in other social services organizations but found rates of PTSD symptoms to be at 33% of the total population. This higher incidence of PTSD symptoms suggests that workers under-report traumatic stress when it is described as vicarious traumatization, that they specifically attribute this to client contact, and that vicarious traumatization is traumatic stress specifically attributed to job-related events. [ABSTRACT FROM AUTHOR]

This article explores juvenile facility frontline staff members' contestations of change of custodial practices aimed at reducing restraints, introducing trauma-informed practices, and downsizing juvenile facilities. Drawing from qualitative research about frontline staff members in a US state undergoing reform, the article points to the ways that the reforms challenge staff members' investments in behavioral control practices as a vehicle for achieving order and control in their everyday lives as workers. It also points to shifts in the broader political economy on punishment at the local, facility level, and the subsequent impact on staff member perceptions of order, control and criminality. [ABSTRACT FROM AUTHOR]

The success of implementation of 'green' practices in hotels depends on employees. Many studies assume that hotel employees perceive 'green' practices positively and, therefore, engage with environmental conservation. Employees can, however, feel negative towards 'green' practices and disengage with their implementation. By interviewing 28 frontline employees in luxury hotels in China, this study explores their perceptions of 'green' practices and related behavioural response. The study finds that employee perceptions can be categorised as positive, neutral, and negative falling into four types: value creation; image building; control system; formalism. These perceptions trigger five patterns of behavioural response ranging from positive (pro-active support), via neutral (passive compliance; indifference) to negative (informal protest; avoidance). The study enables preliminary conceptualisation of complex employee response to environmental sustainability interventions in luxury hotels in China and beyond. The study outlines measures for hotel administrations to facilitate positive staff attitudes to environmental conservation. • Luxury hotel employees perceive and behave towards 'green' practices positively, neutrally, and negatively. • Perceptions are associated with value creation, image building, control system, and formalism. • Behaviour is exemplified by pro-active support, passive compliance, indifference, informal protest, and avoidance. • Showcasing 'green' corporate commitment and rewarding staff 'green' performance are necessary. [ABSTRACT FROM AUTHOR]

Abstract: Despite the current controversial debates about discretion in public bureaucracies in general, and in welfare agencies in particular, the current literature on street‐level bureaucracy mainly assumes that discretion is a distinctive feature of the daily work of public servants. Nonetheless, a pertinent question has not specifically been asked in this literature, that is, given the context of privatisation and increased welfare conditionality in the welfare sector that are seriously challenging welfare frontline staff's commitment to social justice and human rights‐based practices, what are forms of street‐level discretion likely to contribute to improving the quality of welfare services? In this study, we attempt to address this question by exploring discretion displayed by welfare frontline staff in four Australian employment service providers. We argue that emotional labour, especially when being informed by critical empathy, is an important and effective form of street‐level discretion that welfare frontline workers can perform to better support welfare recipients and minimise the punitive aspects of welfare policy. [ABSTRACT FROM AUTHOR]

Background: Group home frontline staff have a critical role in implementing service policies, yet research typically examines implementation issues from an organisational perspective. The aim of this study was to explore the self‐perception of frontline staff about their role in group homes for people with intellectual disability. Method: Constructivist grounded theory methodology guided the study. Data were collected with frontline staff through semistructured interviews and participant observations. Coding and sorting methods were used to analyse participants’ self‐perception. Results: Frontline staff felt they were valuable contributors who knew the service setting and residents well. Despite this staff felt powerless in their roles, excluded from organisational dialogue, stressed and exhausted. Conclusions: Frontline staff have critical insight into service implementation although disability service organisations may limit their capacity to contribute to this. Further action could explore new ways to better nurture frontline staff engagement in organisational dialogue. [ABSTRACT FROM AUTHOR]

There have been recent calls to reconceptualize tourist decision-making models. This study presents evidence for a model that depicts on-site tourist decision making as a socially embedded (discursive) performance in which frontline tourism staff members play key roles. Such performances aim to achieve tourism experiences that serve the multiple interests of participants in the decision-making process. Interviews with frontline staff in Canterbury, New Zealand, revealed a “performance” in which a complex set of discursive skills, interpersonal strategies, and service attributes were displayed. Together these generate—via conversation—socially embedded environments of trust that, in turn, lead to outcomes optimized for decision-making effort, decision justifiability, and the avoidance of negative emotions. Findings are discussed within the framework of the “discursive action model,” which highlights a process that has appropriate tourist experience, deemed authentic, as its goal. [ABSTRACT FROM AUTHOR]

A questionnaire survey was conducted in star-rated hotels in Dandong on the turnover intention causes of the staff (mainly workers in lobby, guest room and catering department) . The results of logistic regression analysis showed that, the work intensity, salary, work environment, management style and employment opportunities are the main causes for the employee to leave their jobs. Accordingly, some suggestions to avoid the causes and motivate the working initiatives are proposed, such as recognizing and meeting employee’s reasonable demands, identifying and managing the hygiene factors and motivational factors, selecting and applying the management mode suitable to the employee’s maturity. [ABSTRACT FROM AUTHOR]