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Reflections - Fifteen Years of Action Research at CPH-NEW

Interview with Dr. Martin Cherniack

Dr. Cherniack has led CPH-NEW's HITEC Project to improve the health of corrections officers.

By Irene Egan

Since 2006, the Center for Promotion of Health in the New England Workplace (CPH-NEW), a CDC Total Worker Health® (TWH) Center of Excellence, has conducted studies to improve working conditions and wellbeing for workers in high-risk occupational settings such as corrections and healthcare. 

CPH-NEW uses an unconventional approach called “Participatory Action Research” (PAR) to empower workers in the research process. This approach has resulted in successful TWH efforts with correctional officers and has established CPH-NEW as a leader in correctional health.

In August 2021, the CHP-NEW correctional health study, "Health Improvement Through Employee Control (HITEC) will conclude after 15 years of success in learning how to apply Total Worker Health in a correctional work setting. In September, HITEC will become a TWH program that is funded by the state of Connecticut and self-managed by the CT Department of Corrections.

We talked with Martin Cherniack, MD MPH, CPH-NEW’s founding co-director, HITEC principal investigator, occupational health physician, and UConn professor of medicine, to look back on CPH-NEW's correctional health research successes and look ahead to future directions for research for this highly vulnerable occupational sector.

“CPH-NEW has always worked with its original first principles – the commitment to Participatory Action Research (PAR) has never been lost,” said Dr. Cherniack, during a recent interview. 

He said that the Center’s research consistently demonstrates the value of engaging workers themselves in efforts to achieve healthy workplaces, as opposed to the “default course” of the field which has been on individual behavior and management training programs. “An empowered workforce can be very creative,” he said, noting that workers have ideas and perspectives “we may not ever have thought of.”

Dr. Cherniack has been the Principal Investigator for the Center’s project, “Health Improvement Through Employee Control” (HITEC), funded through the National Institute for Occupational Safety and Health (NIOSH). Since 2008 he has led CPH-NEW’s work with the Connecticut Department of Corrections.  As part of this project, Center researchers have engaged administrators, supervisors, corrections officers, and union leaders in ongoing participatory action research. The goal has been to create a healthier workplace in jails and prisons, where employee stressors - and their negative consequences - are particularly severe.

Center researchers have helped to create and facilitate Design Teams of employees and supervisors to identify needs, design interventions, and evaluate the results through employee surveys and other evaluations. HITEC Design Teams have instituted changes that corrections officers suggested, such as allocating time and space for documenting incidents and for de-escalation after crisis situations. A mentoring program of new officers by experienced officers has helped to reduce negative health effects of stressful work on the mentees. Strategies to increase healthy eating, exercise, and adequate sleep have been designed by the teams and implemented. An information session for the families of employees was offered, to help them understand the challenges of the job.

Participatory Action Research “is not just engaging people in specific issues,” Dr. Cherniack said. “It’s actually taking them through a process and creating a new way of working.”  Administration, supervisors, frontline officers, and union leaders all have to be committed to the goal and work together. How to accomplish this “is not simple or obvious,” he noted.

“Most initiatives will confront roadblocks that are unimaginable at the beginning, but there are always alternatives,” Dr. Cherniack said. “We have to pay attention to what doesn’t work, even if seemed like a good idea.  It’s not always a ‘failure’ – there are lessons to be learned. We have to ask, ‘Why?’” He said that, “even though as researchers we have to start with predictions, there are always things we could never have predicted. We see them in retrospect – how things have aligned, factors we didn’t consider at first.” 

COVID-19 was one of those unpredictable events and “has had a huge impact on public sector workplaces,” Dr. Cherniack said. “Correctional officers knew they had to be there throughout the pandemic. Our Design Teams were ahead of administration in many instances. They had to deal with the daily challenges of vulnerable inmates, limitations on visitors, and going back to their own families. Labor groups were very farsighted in responding to the changing guidelines about protection. It has been a time of so much added stress, yet the teams kept meeting and were focused on the factors they could control.”

“In the beginning, we couldn’t have predicted that our work in corrections would be so successful,” Dr. Cherniack said, noting that employee/management teams are committed to working together in corrections facilities across the state. “It’s not just a five-minute update at a staff meeting, and it’s not just at contract time that unions are providing leadership,” he said. “People are engaged and passionate about working this way. They have pride in knowing that they are national avatars and an example to others.”

Dr. Cherniack said that it has been rewarding to see the commitment of individual officers and supervisors, but that strategies are needed to sustain the work even through personnel transitions, which are always occurring. “If you just train individuals, transitions can be problematic," he said. He is focused on sustaining what has been achieved by changes in organizational structure and process, and he said that he is encouraged by the increasing interest and adoption of PAR principles. “I hope this is an ongoing and positive avenue for activism.”

Dr. Cherniack shared that he looks forward to continuing his work with the Department of Corrections in Connecticut. He appreciates the support of legislators, such as Cathy Osten, State Senator, who is Chair of the Appropriations Committee and committed to improving corrections operations, and that "We're very fortunate that Congresswoman Rosa DeLauro, Chair of the U.S. House of Representatives Appropriations Committee, strongly supports Total Worker Health on the federal level," he said.

“The ‘karma’ of good relationships with people who have strong community roots can be very beneficial,” he said. “There is so much work to be done in the public sector, especially with high risk workplaces such as law enforcement.” 

Dr. Cherniack’s own community roots in social action and organizing led him to pursue his medical degree in occupational health. “The 70s and 80s were amazing years of flexibility in terms of creating your own medical career, such as combining clinical medicine with research and social action. I have appreciated moving among these roles and bringing what I have learned to each one,” he said. “During those years there was an outstanding peer group of people around the country who were focused on occupational health. It was a very powerful ethos.”

Dr. Cherniack noted that “CPHNEW will continue to face challenges with Participatory Action Research that are very difficult. But we have to design where the real needs are – where the real possibilities are,” he said. In looking to the future, “We can’t be swayed by the past. We have to see new patterns, new forms, how factors inside and outside of the workplace align. We have to listen to people. Attentiveness is important.”

“None of this is easy or simple, but” – he says with a smile - “it’s not impossible.”

The Center for the Promotion of Health in the New England Workplace (CPH-NEW) is a Total Worker Health Center of Excellence, funded by the National Institute of Occupational Safety and Health (NIOSH). CPH-NEW is a joint initiative of the University of Massachusetts Lowell and the University of Connecticut.