Developing a new screening tool of psychosocial hazards

IWH lends tool development expertise to StressAssess, OHCOW’S new measure of toxic workplaces

Published: November 8, 2018

Ridicule and belittlement, gossip and back-stabbing, unclear job expectations, unfair treatment, relentless work demands: research shows people who experience these and other similar psychosocial conditions at work are at risk of developing stress injuries. They’re also at greater risk of a range of negative health outcomes. Consequences for the workplace itself include poor morale and engagement, high absenteeism and high staff turnover.

As chronic mental stress becomes recognized as a compensable work-related injury by a growing number of compensation systems across Canada, workplaces have more reason than ever to tackle toxic work environments as they would any other safety hazard.

To support efforts by workplaces to address psychosocial hazards, the Occupational Health Clinics for Ontario Workers (OHCOW) and the Canadian Centre for Occupational Health and Safety (CCOHS) released a tool called StressAssess earlier this year. The free online survey tool, validated with statistical analysis by the Institute for Work & Health (IWH), can be used by workplaces to anonymously, collectively and confidentially gather information about current work conditions and psychosocial hazards.

The tool was developed in response to a gap in the system’s response to workplace stress, says John Oudyk, OHCOW hygienist and one of the lead researchers behind the tool. Referring to a widely adopted framework of three types of prevention, Oudyk also notes that resources to help organizations tackle stress are generally limited to secondary and tertiary prevention. Secondary prevention, aimed at reducing the impact of a disease or injury that has already occurred, would include workplace mental health awareness and screening programs such as Mental Health First Aid. Tertiary prevention, aimed at softening the impact of ongoing illness or injury, would include employee assistance programs or return-to-work programs.

The one piece that has been missing is primary prevention at the organizational level—changing the workplace so that we reduce stress, says Oudyk, adding that StressAssess can help identify the harmful psychosocial work exposures to address.

Modifying an existing measure

The need for such a tool came up as far back as 2009, when an OHCOW stakeholder sub-committee of union representatives and other worker advocates decided to form the Mental Injuries Tool Group. The group examined and tried out screening tools already available, and reviewed the theories of workplace stress that underpinned the tools. The group ultimately chose the Copenhagen Psychosocial Questionnaire (COPSOQ), developed in Denmark in 1997, because it incorporated many different theories.

The COPSOQ measures psychosocial factors along six dimensions: work demands, work organization, relationships, work values, work/life balance and offensive behaviours. The tool group added to this list—in response to a pilot test of the survey as well as consultations with stakeholders—questions about symptoms (burnout, stress, sleep troubles, and cognitive and somatic symptoms), accident investigation styles at the workplace, and hazards in the physical environment (see sidebar on page 7).

When we piloted the survey, one of the comments we got back was, ‘There are stresses due to safety hazards that we experience in the workplace that aren’t being captured in this questionnaire,’ explains Oudyk. The additional questions touched on safety hazards, workstation ergonomics, physical factors such as noise and lighting, air quality, dangerous chemicals, biological hazards, radiation, driving hazards and working alone.

The group also added, to the category of offensive behaviours, a question on discrimination and another on vicarious offensive behaviour. The research clearly shows that you don’t have to be the victim of bullying or harassment at the workplace to suffer the consequences, says Oudyk. Bystanders are also affected by this type of behaviour in the workplace.

The modified survey was given to a sample of 4,000 workers across Canada in 2016. The responses were then analyzed by IWH Associate Scientific Director and Senior Scientist Dr. Peter Smith to determine the survey’s validity and reliability. With this type of analysis, called confirmatory factor analysis, the aim was to make sure each of the questions contained in the tool actually measures what it is designed to measure.

You would want to make sure that a question about a concept such as job control, for example, brings up answers about that concept only, says Smith. You wouldn’t want the answers to be about another concept such as workload, or even about multiple concepts, such as a mashup of job control and something else. This level of precision is important both to identify the specific work condition that workplaces need to target in their prevention efforts, and to measure any change in that condition as a result of the intervention, he adds.

See related

Many workplace psychological assessment tools and questionnaires are out there. However, some were developed many decades ago in different labour market contexts, and others developed more recently have not been validated, says Smith. OHCOW has done a lot of work to make sure this tool is a good, valid measure of psychosocial conditions in Canadian workplaces of today.

With the validated tool, OHCOW now has a resource to help workplaces start a conversation about toxic work conditions, says Oudyk. Responses from the sample of 4,000 people also provide a country-wide average against which individual workplaces can measure themselves.

OHCOW is very grateful for the guidance and analysis that IWH provided, says Oudyk. Workplaces are finding it easy to use this tool, and we hope that it will help in improving the psychosocial conditions in Canadian organizations.