Designing and evaluating a nutrition intervention to improve the health and wellbeing of construction workers, by PhD student Magdalena Wronska

Eating and food are important to people and a relationship between nutrition, health and wellbeing has been well established. Work is a source of social contact and prestige, as well as providing economic opportunities to pursue healthy choices, while work cultures, schedules, and patterns have a major impact on our eating behaviours. My PhD study explores nutrition knowledge and behaviour amongst construction workers in the UK. This is of particular importance, given that approximately 7% of the UK workforce are employed in the construction industry, and also the high level of work-related ill health in this group. Additionally, in construction, long working hours, high pressure working environments, remote site locations and long commutes make healthy food choices challenging.

This project is the first UK study exploring the effectiveness of a workplace intervention on nutrition knowledge and behaviour amongst employees in the construction industry. For my PhD, which is supervised by Dr Margaret Coffey and Dr Anna Robins, I am designing, developing and evaluating a participatory nutrition intervention, with the purpose of improving the health and wellbeing of construction workers. The first (exploratory) phase of the project, informed the next phases, including the questionnaire development, and intervention design. Focus groups with construction workers and managers took place on three different sites exploring their nutritional practices and eating habits, as well as to identify barriers and facilitators to healthy nutritional choices in the workplace. I investigated perceptions of current health strategies and ways to facilitate healthy nutritional choices amongst construction workers.

Photo by Arron Choi on unsplash

These are some of the things that construction workers told me during my research, which illustrate some of the challenges of achieving a healthy diet for workers in this industry:

“They’ll pick up the fizzy drink or an energy drink. So you smash an energy drink, I’ve seen it on other sites, up the river, people don’t even have lunch sometimes, they’ll just have an energy drink just to get through the day, which, yes, that’s suits me but it’s just full of sugar, it’s absolutely packed”

“I’ll maybe go to the Grub’s Up van that comes around and get rice and chicken covered with cheese. It tastes good, but I know it’s slowly killing me”

“By the time I get home I really can’t be bothered cooking”

“If we’re in B&Bs, which several of us have been at various times over this project, there’s nowhere to store food, no fridges or microwaves”

Winner of the 2017 Lindsey Dugdill Memorial Prize for best PhD–Dr John Hudson

John’s PhD research: wellbeing at work

Realistic workloads, supportive managers, fairness, and a bit of recognition for good work: are things like this too much to ask for employees? I’ve always been interested in work psychology, even before I knew it was possible to study it; after all, who wouldn’t be interested in making work better and less ‘stressful’? Despite recommendations from the National Institute for Health and Care Excellence that preventative interventions (strategies that target potentially stressful working conditions rather than employees’ ability to cope with them) should be prioritised, there is relatively little research of this type. Many years later, and having just completed my PhD looking at how employers might improve work for employees, and I’m probably a bit more realistic about how challenging that can be!

Who wouldn’t be interested in making work better and less ‘stressful’?

Can we make work better?

I was initially surprised when I started my research that the evidence for methods of improving work for employees and supporting their psychological health and well-being was rather mixed; some studies reported reasonable results, but many seemed to suggest they didn’t do any good at all. I soon found that this is in part because preventative approaches are usually very complex and involve lots of people and decisions, as well as relying on effective implementation. On top of that, there are likely to be many contextual and practical factors that can influence the process: unexpected events, organisational changes, limited resources, and even cynical employees, have the potential to derail even the most careful plans. So my initial focus on whether or not preventative approaches were effective quickly shifted to look at why even the most well-intentioned efforts can lead to disappointing results. My research aimed to add to our understanding of the factors that can derail them and learn lessons that can help with future efforts.

 

It’s certainly not all bad news, because there are things that employers can do to improve things, they just need to be aware of some of the pitfalls and get the planning and implementation right. For example, ensuring that employees have a say in identifying what aspects of the workplace should be prioritised, rather than senior managers deciding what’s best for them. Then there are seemingly obvious things – that are often forgotten – which can make a huge difference: communication, and follow-up. If you’re going to start a project to improve your workplace, it is vital to keep employees up to date on plans and progress, and that any promises are followed-up – fail to do that and employees might see yet another ‘well-being initiative’ introduced with great fanfare before it silently disappears under layers of new priorities. Is it any wonder employees might be cynical at times? There’s no one-size-fits-all solution, it’s incredibly complex, but thankfully the evidence suggests there are things that can be done.

Research in the ‘real world’

It can also be challenging to conduct research in organisations – although well worth doing – because, let’s face it, they are not there for the benefit of researchers. They naturally have their own priorities. For example, in my research, the organisation I worked with were supportive of my work and very keen to take action to improve things for their employees. However, because they were severely hampered by substantial cuts to their budget during my PhD project it meant large-scale restructuring was required, making it very difficult for them to fulfil all their original plans. As a researcher this was hugely frustrating, particularly as I had to complete my work within a set timescale, but it was obvious the organisation was being stretched and doing their best under very difficult circumstances. As a result, things didn’t happen when they were supposed to, or didn’t happen at all in some cases; welcome to the ‘real’ world of research! However, it taught me so much and it is probably a better piece of work because of some of these challenges, to be honest. There were also some positive outcomes (and plenty of lessons) for the organisation to use as they continue with their work to support employee well-being. And, as I graduated at The Lowry on the 18th July 2017, and having progressed to a lecturing post at Staffordshire University, I was able to look back with so much pride and wonder how on earth I got there!

The organisation was very keen to take action to improve things for their employees

Why the Lindsey Dugdill award is so special

The graduation was made all the more special by receiving the Professor Lindsey Dugdill award for my PhD thesis. Knowing how much Lindsey meant to her many friends at Salford, it’s quite hard to adequately express how much more this award means as a result. I was fortunate to meet Lindsey during my PhD, but I’d like to finish with an experience that took place several years previously when I submitted a proposal for a different PhD to the university. I had lots and lots of questions, and I was advised to contact Lindsey as the proposal was in her field. She was incredibly generous with her time and advice – spending her own time talking through my ideas and giving feedback. It is worth emphasising that this is despite Lindsey not being involved in the project, and had never even met me before – I was just a potential student with an interest in Lindsey’s field of expertise (or one of them!). It would be a better story if my application had been successful but circumstances at the university meant the funding was unavailable – Lindsey still got in touch with some encouragement. I cannot tell you how much I appreciated the time and trouble she took to help someone she didn’t even know, and I was delighted to be able to tell her in person when I actually joined the University a couple of years ago. Having met Lindsey, and having worked alongside so many of her close friends in Public Health and Psychology, I know this sort of support and encouragement was not a one off, which says it all really. A lovely person.

John Hudson receives his award from Dean of Health Sciences Kay Hack

By John Hudson

About one of our PhD Alumni – Dr James Chandler

James is a researcher with experience using both qualitative and quantitative research methods and an understanding of the social determinants of health, particularly the role of work and how the psychosocial work environment impacts on employees’ mental and physical health and wellbeing.

His PhD explored the impact of working in a social enterprise on employee health and wellbeing through the lens of ‘good’ work, culminating in the development of an empirically informed conceptual model that illustrates how working in a social enterprise may lead to improved health and wellbeing outcomes.

Following the completion of his PhD, he secured the role of Researcher at the Work Foundation, a think-tank based in London, which is dedicated to promoting the concept of ‘good’ work and its benefits for employees and employers alike. Drawing on the knowledge and research skills acquired through his PhD, he is, primarily, focused on developing evidence-based policy recommendations relating to the health and wellbeing at work agenda. Recent projects include: overseeing the development of an ‘early intervention toolkit’ designed to make the case, using the example of musculoskeletal conditions, for the implementation of early intervention services across the European Union; and a service evaluation of a newly-formed early intervention clinic, based in Leeds, which aims to get people signed-off work with a musculoskeletal condition back to work as soon as possible. To read more about this see – http://earlyinterventiontoolkit.com

About James

James was awarded a BA (Hons) in History and Politics from Keele University in 2008 and an MA in Political Economy from the University of Manchester in 2010. His MA dissertation explored the relationship between income inequality and health, which focused his interest on the areas of public health and health inequalities. Prior to starting a PhD in Public Health at the University of Salford, James conducted a literature review for the university in 2011 on the impact of working for a social enterprise on employee health and wellbeing – this project served as a platform for his PhD research.

Twitter – @jbchandler

Details of James’s PhD

His PhD explored the experience of working for a social enterprise – an organisation with social aims that uses profits for that purpose – and whether these organisations provide good quality work conducive to employee health and wellbeing. Using a mixed-methods approach, comprising (i) a mapping study that identified social enterprises active in the Greater Manchester region, (ii) semi-structured qualitative interviews, and (iii) a survey completed by social enterprise employees across the region, the research finds that social enterprises provide good quality work environments conducive to employee health and wellbeing – furthermore, when compared to a national sample of individuals working in non-social enterprise organisations, social enterprise employees report significantly higher levels of control over their work, support at work, job satisfaction and job-related wellbeing.

Chandler, James 2016, A study to explore the impact of working in a social enterprise on employee health and wellbeing in Greater Manchester , PhD thesis, University of Salford.

 

New reports :

Work Foundation’s Health at Work Policy Unit publishes its latest report: Who cares? The implications of informal care and work for policymakers and employers.

Other papers in the series include:
More than ‘women’s issues’
Men’s mental health and work: the case for a gendered approach to policy
• Managing migraine: a women’s health issue?

For more information, see our background paper and accompanying infographics.

Read the full report or executive summary.

Please feel free to contact the report’s author, Dr James Chandler, for more information.