The Intersecting Consequences of Race-Gender Health Disparities on Workforce Engagement for Older Workers: An Examination of Physical and Mental Health

The dramatic growth of older adults’ labor participation over the past 25 years, including women and people of color, is reshaping the American labor force. The current study contributes new knowledge concerning why individuals over age 50 years may be working longer despite negative impacts of deteriorating physical and mental health associated with aging. Inquiries regarding who continues to work and why can be answered, in part, by addressing how workforce engagement and health are shaped by notable social inequities along the dimensions of age, race, and gender. Guided by cumulative advantage/disadvantage and intersectionality frameworks, we examine whether having multiple chronic conditions (MCC)—two or more physical conditions—and depression affect workforce participation. Using multinomial logistic regression models, we analyze the 2014–2016 waves of the Health and Retirement Study ( N = 4250). Findings reveal that having multiple chronic illnesses increase the likelihood of labor force exit, especially among workers who also have depression. We also discover intersectional nuances which illuminate complex race-gender dynamics related to health and work processes in later life. We conclude with recommendations for workplace policy that promote the retention of older workers with chronic illness and depression and aim to decrease disparities in older workers’ work engagement.

Dementia-Friendly America Recognition: Strategies for Urban, African American Communities

Dementia-Friendly America is a network of communities across the United States who have committed to a process to support people living with dementia and their caregivers. Through technical support from Dementia Friendly Illinois, CATCH-ON, a HRSA Geriatric Workforce Engagement Program, has identified key characteristics for the 17 communities in Illinois achieving national recognition and for communities that have engaged but not yet achieved national recognition. In addition to communities in rural regions, urban communities with a large number of African Americans residents have necessitated more grassroots engagement than other communities. Partnerships are vital for providing information and education about the movement and for supporting multi-sectoral engagement. This presentation highlights barriers and facilitators in diverse communities, particularly urban African American communities, becoming recognized by Dementia Friendly America.

Social Work and Social Care: Mapping Workforce Engagement, Relevance, Experience and Interest in Research

Evidence-based practice (EBP) has been promoted within social work/social care, with emerging evidence of benefit to practitioners and service users. Advocates argue that EBP enables practitioners to have the skills to interpret and evaluate evidence and be actively involved in research. This project aimed to evaluate awareness, experience/skills and value of research, and explore barriers to engagement with research. A cross-sectional survey was undertaken across a diverse range of social work/care staff at a large National Health Service (NHS) Foundation Trust and partner Local Authority. The survey included both closed and an open-ended response to facilitate a mixed method analysis. In total, 208 staff responded (55 percent response) and findings show a high rating on the relevance of research to professional development (73 percent); however, a low level of actual involvement (10 percent) and low levels of confidence/knowledge across a range of research skills. Identified barriers include a lack of knowledge on where/how to begin, lack of evidence that it improves practice, the potential to threaten practice and low capacity and time. These findings highlight a potential gap between a current drive for social work/care to be more evidenced based and the ability of social work/care to enact this approach.

Human resources for health talent management contribution: A case for health systems strengthening in the public health sector

Talent Management is an essential component in transforming health systems if carefully implemented for the public sector especially in low income countries. In Zimbabwe public health sector, talent retention and engagement are viewed as amongst the challenges affecting the realisation of effective performance and productivity from the existing Health workforce. Largely, modern health care systems lack robust strategies to identify and utilize employee talent essential to help attain organisational citizenship. The study reviewed the relevancy and effectiveness of talent management practices in the public health sector using a case study of Parirenyatwa Group of Hospitals, one of the major referral hospitals in Zimbabwe. The study aimed at closing the talent pipe-line gaps as part of the Health Systems Strengthening initiative towards bringing about talent retention and engagement amongst the health workforce in public sector settings. The study assessed the impact of the existing talent management initiatives focusing on variables; recruitment and attraction perspective, compensation and rewarding component, health workforce succession management and implemented performance management system. The study obtained cross sectional data collected through a designed tool following a purposive (non-probability) sampling technique from a sample of n=200 existing health management team to assess the perception of implemented talent management approaches. The study further used responses from n=450 randomly selected health professionals recruited in the last 3 years prior to the survey to analyse the association between the variables on talent management practices namely (recruitment and selection, compensation and rewarding, succession management and performance management system) and the age of health workforce to employee engagement. The data on recruited cadres was obtained from the existing Hospital Human Resources for Health Recruitment Database. The research revealed that talent management in public health sector currently suffers from theoretical problems since the existing Human Resources for Health literature concentrates on anecdotal information. The human resource practitioners need to come up with more involving workplace activities to demystify the theory that millennials are generally finding it difficult to engage. In addition, the public sector succession planning strategies would need to be in place for the millennials well in time to adequately replace the considerable number of those at retiring stages. The Logistic regression analysis revealed recruitment and attraction perspective, and succession management positively influence health workforce engagement while adherence to implementing performance management system negatively affected employee engagement. Compensation and rewarding practices in a public health set up proved an insignificant variable to health workforce engagement hence study concluded further analysis on the impact on wider target group. The study revealed as the age increases, the health workforce become more engaged and self-motivated to develop their personal talent, thus theory suggests such are ‘Baby Boomers’ age group that do not need much push and are prepared to perfect their work talent for the benefit of the health system. The role of performance management system must be equally elevated within health system initiatives in order to achieve ultimate health workforce engagement. The study recommended the public health sector to incorporate in its human resources policy, a strategy for managing and utilisation of talent from the different health workforce generations within the health system. In improving the performance of public health systems, talent management need to be put forward in the health systems strengthening agenda in order to build highly engaged health teams. Talent management practices become essential and if carefully implemented, are likely to help public health systems retain rare skills especially in highly specialised functions. Furthermore, the organisations need to synchronise its strategic plan with the talent management strategy. There must be continuous capacity building of human resources departments to firstly own policies that influence talent management so as to ensure ultimate health workforce engagement.

Digital Health Entrepreneurship

Digital health technologies can promote advancements in mental healthcare using methods of electronic data collection and high-powered computing. There is a growing recognition that implementation of these technologies can address the quadruple aim in healthcare by improving health of populations, increasing quality of care, reducing costs, and increasing workforce engagement. The convergence drivers of innovation in digital health are described in a discipline referred to as digital health entrepreneurship. This chapter introduces digital health entrepreneurship, and its relationship to convergence science, and describes the strategies to advance digital health entrepreneurship in mental health.

Does integrated health and care in the community deliver its vision? A workforce perspective

PurposeThe purpose of this paper is to explore and capture workforce perceptions, experiences and insights of the phenomena of integrated care (IC) in a community health and care NHS trust in England; including whether there are any associated factors that are enablers, barriers, benefits or challenges; and the level of workforce engagement in the process of integrated health and care.Design/methodology/approachA qualitative design based on an interpretivist research paradigm was used with a purposive sampling technique. Five in-depth semi-structured interviews were conducted with community nursing, social workers and allied health professionals. Colaizzi's (1978) descriptive phenomenological seven-step method was applied to analyse data, with the emergence of 170 significant statements, 170 formulated meanings and 8 thematic clustering of themes to reveal 4 emergent themes and 1 fundamental structure capturing the essential aspects of the structure of the phenomenon IC.FindingsThis study revealed four interdependent emergent themes: (1) Insight of IC and collaboration: affording the opportunity for collaboration, shared goals, vision, dovetailing knowledge, skills and expertise. Professional aspirations of person-centred and strength-based care to improve outcomes. (2) Awareness of culture and professionalism: embracing inter-professional working whilst appreciating the fear of losing professional identity and values. Working relationships based on trust, respect and understanding of professional roles to improve outcomes. (3) Impact of workforce engagement: participants felt strongly about their differing engagement experience in terms of restructuring and redesigning services. (4) Impact of organisational structure: information technology (IT) highlighted a barrier to IC as differing IT platforms prevent interoperability with one system to one patient. Shared positivity of IC, embracing new ways of working.Originality/valueThis study proposes considerations for future practice, policy and research from a local, national and global platform, highlighting the need for any IC strategy or policy to incorporate the uniqueness of the “voice of the workforce” as a key enabler to integration developments, only then can IC be a fully collaborative approach.

Electronic care planning and care worker engagement

In the wider context of the advancement of digital technologies in healthcare, electronic care planning and recording systems are becoming increasingly prevalent in social care settings in the UK. At the same time, the engagement of employees is an important concern for senior managers of these services, where turnover rates are high and human resources are often scarce. This study researches the impact upon employees of the implementation of electronic care planning in two organisations running multiple social care services. Following a review of technology acceptance and engagement literature, hypothesised developments of technology enhanced engagement and concomitant increases in motivation, empowerment and productivity are researched. An exploratory sequential mixed methods approach is utilised, bringing together qualitative and quantitative data for analysis. Findings suggest that care planning technology produces a positive engagement impact, broadly confirming the hypotheses. Overall workforce engagement of both organisations studied is shown to be very high. Correlation analysis shows that, while not all employees recognise the engagement impact of the care planning technology, those who do also demonstrate the highest levels of motivation, empowerment and productivity. Demographic differences are evaluated as moderating influences, but are not found to be highly significant in this study. This is a cross-sectional short-range study, and recommendations for future longer-range and broader research are considered. In the light of the indicated engagement benefit of electronic care planning technology, implications for managers of services, application developers and social care workers are considered.