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Title: An integrated approach to improve mental health among construction personnel in Nigeria
Authors: Nwaogu, Janet Mayowa
Degree: Ph.D.
Issue Date: 2022
Abstract: Mental ill-health has been tagged as a silent epidemic in the construction sector. However, despite the increase in mental ill-health within the industry, integrated interventions to ensure a positive response to daily stressors and reduce the onset of the stressors are lacking. While efforts for intervention specific to high-income economies are underway, this study attempted to meet such demand by focusing on lower-middle-income economies using Nigeria as a reference. On this premise, the study aimed to develop an intervention framework for the prevention and mitigation of mental ill-health in the construction industry of Nigeria with a view to improving the health and well-being of construction personnel. The study aim was achieved by setting out four objectives: identify and assess the risk factors for mental ill-health and protective factors for mental health among construction personnel; assess the effect of work pressure in construction on the physiological health of construction personnel; evaluate potential mental ill-health solutions and develop a mental ill-health prevention and mitigation intervention framework for the Nigerian construction industry. The study adopted the mixed method technique and focused on supervisors and tradesmen. Data was collected using purposive sampling from 174 construction supervisors, 110 tradesmen, and 45 experts. Out of the supervisors and tradesmen, 56 were recruited for an experimental procedure to achieve objective two. A range of validated psychometric instruments such as the Patient Health Questionnaire, Generalized Anxiety Disorder Questionnaire, and Brief Resilience Scale were employed in addition to self-developed questions to collect data during the quantitative survey. Data from the quantitative methodology involving questionnaire survey were analyzed using mean score, relative importance index, fuzzy synthetic evaluation, univariate logistic regression, and chi-square, while the experimental data were analyzed using mean and multiple regression analysis. System dynamics modeling and structural equation modeling were used to develop the intervention framework.
Logistic regression deduced that the prevalence rates of depression, anxiety, and suicidal ideation among supervisors were 55.1%, 14.8%, and 9.2%, respectively, and 74.5%, 36.4%, and 14.6%, respectively, among tradesmen. It was deduced that modifiable work-related risk factors include work-home/life imbalance, lack of medical subsidies, and fear of failure. Univariate logistic regression revealed that problem-focused coping strategies are protective against anxiety, as construction personnel who employed skills related to planful problem-solving, positive reappraisal, and seeking social support were less likely to experience anxiety. Resilience was confirmed to be a significant predictor of coping strategy and a moderator in the coping strategy and mental health path. Heart Rate Variability (HRV) analysis showed that within 150minutes of work schedule, tradesmen and supervisors were subjected to elevated and normal stress intensity, respectively. After which both tradesmen and supervisors had a sleep score of 74% indicating fair sleep quality. Multiple regression showed that HRV data collected within 150mins accounted for approximately 50% variance in the sleep quality. Multiple regression revealed that although construction personnel were subjected to excessive sympathetic nervous activity resulting in an increased need for recovery, proper recovery was disrupted due to intense reduced parasympathetic activities (resting time) during the day. Regarding the intervention strategies (i.e., job resources) to improve mental health in the industry, experts and supervisors indicated that policies that celebrate employees' success and ensure sustainable retirement plans are most important. On grouping the strategies into constructs, it was also deduced that constructs that motivate employees and build interpersonal relationships were essential. Using modeling and simulation techniques, this research highlighted the need for construction firms to holistically engage primary, secondary, and tertiary intervention strategies that target the organization and individual level for a conclusive mental health and wellbeing outcome. This simulation result suggests that to mitigate and prevent mental ill-health prevalence, risk factors related to job demand need to be reduced by half. In contrast, job control and support factors need to be improved by almost two times to maintain their protective ability. Finally, a mental ill-health prevention and mitigation framework that details an integrated mental health and well-being system was developed and validated. The system will assist in improving mental health in the Nigerian Construction industry. This study recommends that the outlined intervention strategies should form the basis for policy/decision-making regarding appropriate measures to implement in the Nigerian construction industry.
Pages: xxvi, 342 pages : color illustrations
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