Multilevel Effects on Stress focused on Individual, Workplace, and Neighborhood factors among 9-1-1 Telecommunicators

Abstract

About one in four 9-1-1 call center telecommunicators experienced post-traumatic stress disorder (Lilly & Allen, 2015). The evidence on stress associated with individual, institutional, and neighborhood levels are well known; however, comprehensive assessments of effects on stress have not been studied among 9-1-1 telecommunicators (TCs). This study aims to examine multilevel effects on stress regarding three factors: individual characteristics, workplace conditions, and neighborhood effects based on the socioecological model. A secondary analysis was conducted using data collected as part of a randomized controlled trial that evaluated a multilevel stress reduction intervention for 9-1-1 telecommunicators in call centers across the United States and Canada. The parent study collected the data on stress symptoms, resilience, mindfulness, overcommitment, job-demand, and social support at workplace. Neighborhood data (e.g. median household income) were collected from the U.S. Census Bureau. Mixed-effects logistic regressions were conducted to examine what effects were significantly associated with 9-1-1 TCs’ stress. Results showed that all the individual characteristics (e.g. resilience, mindfulness, and overcommitment) and all of the workplace conditions (e.g. job-demand, social support at work, and mandatory overtime) were significantly associated with stress, whereas the neighborhood factor was not. Less resilience, less mindfulness, greater overcommitment, greater job-demand, less social support, and having mandatory overtime were all associated with greater stress. In the multivariable model, less mindfulness and greater overcommitment were significantly associated with greater stress controlling for all covariates (OR 0.17; 95%CI 0.10, 0.28; OR 1.19; 95%CI 1.07, 1.31). This study supports the importance of a multifaceted approach to improve stress reduction programs for 9-1-1 telecommunicators. Also, the inclusion of a neighborhood effect is a novel way of assessing stressors for 9-1-1 telecommunicators even though we did not find the evidence of neighborhood effects associated TCs’ stress. This study highlights that mindfulness and overcommitment are critical predictors of stress among TCs.