Helen M. Nichols

Managing cancer and employment: Decisions and strategies used by breast cancer survivors employed in low-wage jobs

ABSTRACT Advances in breast cancer screening and treatment have led to an overall 5-year survival rate of 90%. Many of these cancer cases are diagnosed in working women. Few studies have explicitly examined the cancer–work interface, as experienced by low-wage earning women with breast cancer. This study uses in-depth, semistructured interviews with 24 low-wage breast cancer survivors to identify employment decisions and factors that influenced or enabled these decisions, and examine the individual strategies and workplace supports used to manage the cancer–work interface among a subset of women (n = 13) who continued to work. Future research areas and clinical implications are discussed.

Advance Care Planning Communication: Oncology Patients and Providers Voice their Perspectives

Advance care planning helps to ensure that patients’ end-of-life preferences are understood and discussed with providers. It is an important component of patient-centered care, particularly when patients are facing life-limiting illness. It also has ethical implications for providers, yet evidence suggests that these conversations are not always occurring, particularly in underserved populations. The aim of this study was to understand the challenges and personal beliefs regarding ACP through interviews with patients undergoing active cancer treatment and their oncology providers. This study took place at an urban, multispecialty cancer center in the mid-Atlantic region where approximately 1400 patients are treated each year. Findings revealed differences among both patients and providers in terms of their ACP knowledge, preferences, and practices. Overall, 70% of patients were familiar with advance directives (100% of White patients and 45.5% of Black patients), yet only 35% of them reported having completed one (55.6% of White patients and 18.2% of Black patients, although not statistically significant). Most providers (70%) held ACP conversations with patients with advanced illness only. They tended to make assumptions about the amount of information that patients desired and noted the significant challenges that were inherent with these types of conversations. Overall, ethical implications are inherent in ACP as patients are making medical decisions without always having necessary information. There are various reasons why providers may not supply information regarding potential outcomes and end-of-life planning and why patients may not request (or know to request) more medical information.

How Does Supervisor Support Influence Turnover Intent Among Frontline Hospital Workers? The Mediating Role of Affective Commitment.

Turnover among frontline hospital service workers can disrupt organizational effectiveness, reduce profitability, and limit the ability to provide high-quality, patient-centered care. This concern is compounded by the increasing reliance on frontline supervisors to manage this workforce, often without necessary training and support. However, research addressing the relationship between frontline supervisor support and intent to turnover among service workers and the process by which these variables are related is limited. By surveying 270 housekeeping and dietary service workers employed at 2 US hospitals, this study examined the relationship between supervisor support and turnover intent and assessed the mediating role of affective commitment between supervisor support and intent to turnover. Turnover intentions were lower for workers who reported greater levels of supervisor support and affective commitment; both supervisor support and affective commitment were significant predictors of turnover intent when tested individually. However, when controlling for affective commitment, supervisor support no longer predicted turnover intent, indicating that affective commitment fully mediated the relationship between supervisor support and intent to turnover. Implications for further research and organizational practice are discussed.

Measuring Work–Life Conflict Among Low-Wage Workers

Objective: Most measurement research that addresses work–life conflict (WLC) has been conducted with higher wage professional workers or mixed samples of workers; little research has focused specifically on low-wage workers. The aims of this study were to (a) evaluate a bidirectional WLC scale that uses established measurement items to determine its applicability among low-wage workers using a national data set, and to (b) test the consistency and validity of this scale using a second nationally representative sample of low-wage workers. Method: We conducted exploratory and confirmatory factor analyses using 2 samples of low-wage workers from the National Study of the Changing Workforce, a nationally representative sample of the U.S. workforce. Analyses were limited to hourly, nonexempt workers who were employed in low-wage jobs that paid less than

A Systematic Review of Community Health Workers’ Role in Occupational Safety and Health Research

31,800 per year or

Correction to: A Systematic Review of Community Health Workers’ Role in Occupational Safety and Health Research

15.29 per hour (N = 672). Results: Using a bidirectional WLC scale, the 2-factor model showed excellent fit to the data. However, areas of misfit were still present and establish the need for further research to fully understand the meaning of WLC for low-wage workers. Conclusions: Model results, implications for practice, and areas for future research are discussed.

Abstract 3277: The influence of cancer on working poor and working non-poor cancer survivors’ work productivity, employment and quality of life

We systematically reviewed the literature to describe how community health workers (CHWs) are involved in occupational health and safety research and to identify areas for future research and research practice strategies. We searched five electronic databases from July 2015 through July 2016. Inclusion criteria were as follows: (1) study took place in the United States, (2) published as a full peer-review manuscript in English, (3) conducted occupational health and safety research, and (4) CHWs were involved in the research. The majority of 17 included studies took place in the agriculture industry (76%). CHWs were often involved in study implementation/design and research participant contact. Rationale for CHW involvement in research was due to local connections/acceptance, existing knowledge/skills, communication ability, and access to participants. Barriers to CHW involvement in research included competing demands on CHWs, recruitment and training difficulties, problems about research rigor and issues with proper data collection. Involving CHWs in occupational health and safety research has potential for improving inclusion of diverse, vulnerable and geographically isolated populations. Further research is needed to assess the challenges and opportunities of involving CHWs in this research and to develop evidence-based training strategies to teach CHWs to be lay-health researchers.

Cancer and Employment Issues: Perspectives from Cancer Patient Navigators.

The original version of this article unfortunately contained a mistake in the affiliation of co-author Ashley M. Bush.

Facilitating Student Safety in Communities: Applying an International Model in an Urban U. S. City

Employment issues are cited as one of the most common unmet psychosocial needs of cancer survivors; specifically, patients indicate they want more information on how to navigate working during their illness, the return to work process and how to manage the immediate and long-term effects on job productivity. Yet, most oncology care providers feel limited in their ability to address this topic with patients, citing minimal guidance, limited access to resources they feel clients need to achieve work-related goals, and concerns regarding their knowledge of how cancer may impact work. Likewise, supervisors of employees diagnosed with cancer are ill-prepared to manage the needs of cancer survivors beyond the standard referral to human resources. One limitation of the existing research on cancer and employment is that most studies have only examined these issues among higher income and more educated cancer survivors. The employment experiences of low-wage and less educated cancer survivors have been understudied. This is a significant gap in the research on cancer survivorship and work given the massive growth of low-wage jobs in the US since the 2008 Great Recession. The employment circumstances are significantly different for workers in low-wage jobs than they are for other workers. Thus, the effects of cancer on the work productivity of working poor and working non-poor may vary and consequently may have different effects on long-term employment and quality of life for cancer survivors. This study addresses this gap in the cancer survivorship literature by examining whether there is variation in the effects of cancer on the work productivity of working poor and working non-poor cancer survivors and its radiating effects on employment and the quality of life of cancer survivors. Using data from the Medical Expenditure Panel Survey (MEPS) and the MEPS Cancer Survivorship Supplement, this secondary data analysis will study cancer survivors who were employed at the time of their cancer diagnosis, comparing the effects of cancer on work productivity among working poor and working non-poor respondents and determining whether differences in work productivity influence long-term employment and quality of life. Preliminary results indicate that a higher percentage of working poor cancer survivors were less productive at work due to cancer and reported lower current employment rates and quality of life indicators in comparison to working non-poor survivors. Study results could help oncology medical teams, supervisors, and human resources professionals assist working cancer survivors during this transition period in their lives. Note: This abstract was not presented at the meeting. Citation Format: Helen Nichols, Kathleen Tracy, Paula Rosenblatt, Robin Vanderpool, Jennifer Swanberg. The influence of cancer on working poor and working non-poor cancer survivors’ work productivity, employment and quality of life [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 3277. doi:10.1158/1538-7445.AM2017-3277