Workplace health friendliness: a cross level model for predicting workers' health.

Two separate studies conceptualized the health friendliness of a workplace, the first qualitatively through content analysis of interviews with 69 nursing superiors about the means employed by their workplace to promote staff health. Findings supported the conceptualization of workplace health friendliness, which was further validated against the staff's health indicators. The second study tested a model explaining the cross-level effects of workplace health-friendliness initiatives on workers' health. The model depicted workers as rational human beings calculating costs/benefits in deciding whether to commit to those initiatives. Benefits represent workers' potential gains through compliance; costs represent their potential losses. Perceived social costs were noted as a possible cost; a worker's perceived stress signaled that he or she might benefit from joining health-friendly initiatives. Analysis of data from 45 nursing units supported the cross-level model: workplace health friendliness was positively associated with workers' health and perceived social costs and stress moderated that link. Accordingly, workplace health friendliness should be regarded as the joint responsibility of the workers and the organization, and attention should be paid to the processes whereby these initiatives become enhancers or inhibitors of workers' health.