Abstract
Purpose:
Examine the moderating role of perceived organizational and coworker support on the relationship between job stress and type 2 diabetes risk among employees.
Design:
A cross-sectional survey was administered to employees at the workplace.
Setting:
One national retail organization.
Participants:
Baseline data were obtained from 1595 employees in 21 retail stores.
Measures:
Self-reported organizational and coworker support to encourage and fulfill job responsibilities and job stress. Diabetes risk was calculated using age, gender, race/ethnicity, blood pressure, physical activity, weight status, and self-reported diagnosed type 2 diabetes.
Analysis:
Multilevel multiple regression was conducted to test the interaction effect of support on the association between job stress and diabetes risk.
Results:
Mean age was 37.95 years (±12.03) and body mass index was 26.72 (±4.95). Three percent of participants reported diagnosed diabetes. Organizational support was positively associated with coworker support. Both were negatively associated with job stress. Organizational support, but not coworker support, moderated the relationship of job stress with diabetes risk. Participants with greater perceived organizational support had lower diabetes risk scores compared to those with lower perceived organizational support.
Conclusion:
Organizational support may be a key factor for workplaces to reduce stress and diabetes risk. Further testing of organizations’ supportive role on employee health may be helpful in developing future workplace programs.
Purpose
The workplace is an important setting to promote positive health behavior changes among adults. Long work hours and excessive demands can cause stress, leading to negative effects on health. 1 Adults who perceive greater stress may also have increased risk of weight gain and type 2 diabetes. Social support in the workplace is a promising practice for reducing work-related stress. 2 However, few studies examine the interaction of work-related stress and support at work on health. The purpose of this article is to explore the role of perceived coworker and organizational support on perceived stress levels and diabetes risk in a sample of retail workers. We hypothesize a moderating role for perceived organizational and coworker support on the relationship between job stress and diabetes risk among employees.
Methods
Design
The present study includes cross-sectional data from the baseline data collection of a larger study. Details on recruitment, enrollment, and previously reported results are available elsewhere. 3
Sample
The sample is from a national retail employer that includes 21 stores from 4 operational districts within the Southern US region. The sample for this study was demographically similar to the employee population of the company. 3 Employees at all levels were encouraged to participate. Surveys were completed during workdays. The analysis included 1595 employees with complete data on organizational support, coworker support, job stress, and diabetes risk score variables.
Measures
Organizational support (9 items) 4 and coworker support (7 items) 5 were measured by previously validated scales to assess work environment and interpersonal relationships to fulfill job responsibilities. Items were scored from 1 (disagree strongly) to 5 (agree strongly). Separate mean scores were calculated. For the parent study, internal consistency was 0.91 for organizational support and 0.92 for coworker support. 3 Job stress focused on employees’ perceptions and reactions to stressors at work and was measured with a previously validated scale of 6 items to assess responses to stressful situations at work. 6 Items were scored from 1 (never) to 5 (very often), with a mean score used in analyses. For the parent study, internal consistency was 0.88. 3
Diabetes risk was calculated using the American Diabetes Association (ADA) Diabetes Risk Test for type 2 diabetes, based on 7 factors: age, gender, diagnosis of gestational diabetes, family history, high blood pressure, physical activity, and weight status. 7 Points were summed and higher scores indicated greater risk of diabetes. The formula used for the current study included a total risk score with 2 points less than the ADA score because questions regarding gestational diabetes diagnosis and family history were not asked in the parent study.
Analysis
Statistical analyses were conducted with SAS v 9.4 (Cary, North Carolina). Descriptive statistics were calculated for age, body mass index (BMI), diabetes risk score, organizational support, coworker support, job stress, gender, race, and diagnosed diabetes. Pearson correlations were calculated among diabetes risk score, organizational support, coworker support, and job stress. A multilevel multiple linear regression was conducted to assess the influence of organizational support, coworker support, and job stress on diabetes risk. Participants were nested within their geographic work districts to account for differences in job demands and support by district. Interaction effects between job stress and organizational support and job stress with coworker support were tested and illustrated. 8 The regression model controlled for gender and race/ethnicity. Results are interpretable at α = .05.
Results
The analyzed sample was comprised of 34% female, with a mean age of 37.95 (±12.03) years old, mean BMI of 26.72 (±4.95), mean organizational support was 3.46 (±0.78), mean coworker support was 3.39 (±0.79), mean job stress was 2.62 (±0.91), and mean diabetes risk score 2.64 (±1.63). Only 3% of participants reported diagnosed diabetes. The racial/ethnic background of the participants included white (80%), black (7%), and Hispanic (5%).
Pearson correlation coefficients indicated a strong, positive relationship between organizational and coworker support (r = .58, P < .0001) and moderate, negative associations for job stress with organizational (r = −.46, P < .0001) and coworker support (r = −.39, P < .0001). Associations for diabetes risk with support variables were weak (r = .04-.05). The inverse association between job stress and diabetes risk was also weak (r = −.05, P < .05).
Results of the regression analyses indicated that the interaction term between coworker support and job stress was nonsignificant, and therefore was removed from the model. The interaction effect between job stress and organizational support was significant (P = .096) and is shown in Figure 1. Interestingly, as job stress increased diabetes risk decreased. But diabetes risk was lower for participants who reported higher organizational support compared with participants reporting lower levels of organizational support. It is possible that organizational support overrode any effects of coworker support.
Relationship between job stress and diabetes risk for different levels of organizational support.
Discussion
Summary
Our study aimed to understand the interaction effects of organizational and coworker support on the relationship between perceived stress and diabetes risk. Results indicated a significant, though modest, association for organizational support as a moderator but not coworker support. Previously, the Healthy Work Organization model illustrated sequential effects of organizational support on job stress. 3 This research adds to the model by showing concurrent effects of organizational support on job stress. 3 This may suggest that organizational support plays an important role not only as a critical antecedent effect found in the original model but also as a buffer to distal health outcomes.
The finding of no interaction effect for coworker support is consistent with a study of navy enlisted personnel that also found no moderation effect for coworker or leadership support for the stress and strain relationship in the workplace. 9 Although an employee may have high support from their coworkers, this type of support may not be sufficient to reduce employee stress and their risk for diabetes. Existing literature has largely examined the impact of stress on diabetes management and less on diabetes risk. 10,11 A supportive organization may affect employee health status and job satisfaction. 12
Limitations to this study include that it is cross-sectional, with a sample from retail employees. Causality cannot be inferred and the findings may not generalize to other types of occupations. Only complete cases were included. The reasons for missing data on the perceptions of support or stress are not known and so there may have been selection bias. Another limitation is that our diabetes score does not represent the full diabetes risk score defined by the ADA. Because this was a secondary data analysis from a larger study, we were unable to include questions on family history and gestational diabetes diagnosis, potentially artificially reducing the diabetes risk score for some participants. Although other studies define diabetes risk differently and with more or less variables incorporated in their risk scores, 13 the current score provides a strong proxy for diabetes risk. 14
SO WHAT? Implications for Health Promotion Practitioners and Researchers
What is already known on this topic?
Existing literature has largely examined the impact of job stress on diabetes management but less on diabetes risk.
What does this article add?
A novel aspect of this analysis is the inclusion of diabetes risk in relation to stress and support at work. Very few studies examine organizational and coworker support as a moderator variable on job stress and health outcomes.
What are the implications for health promotion practice or research?
Future research may examine support at work and its effect on other health-related outcomes. Workplace health promotion programs may consider how additional forms of organizational support can contribute to the health and well-being of employees.
Conclusion
This study highlights the need to further investigate organizational support as a way to reduce diabetes risk among employees. Organizational support may buffer stressful conditions at the workplace.
Footnotes
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.