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Publications of 2026
Comparing barriers to employee assistance program utilization in Canada and the United States using natural language processing and machine learning
Sana Siddiqui, Javier Mencia Ledo, Raihana Premji, Hong Ki Chloe Lau, Kishana Balakrishnar, Charlene Choi, Paula Allen, Allison Kelly, Marilyn Grand’Maison, Donia Obeidat, Ali Bani-Fatemi, Behdin Nowrouzi-Kia
Employee Assistance Program (EAP)s provide critical mental health support, yet utilization remains low in both Canada and the United States. Although qualitative studies have examined general barriers to EAP use, few have compared country-specific perceptions. This study explores barriers to EAP usage and explores potential differences in barriers between Canadian and American workers using natural language processing (NLP). This mixed-methods study, involving data transformation, included 30 semi-structured interviews with EAP-eligible employees (aged 18–65 years) in Canada and the US who had not previously used EAP services. Interviews were analyzed thematically using an inductive approach in alignment with Braun and Clarke’s Thematic Analysis. The qualitative portion of this study was reported in accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. In Phase 2 of the study, a BERT-based NLP model was trained to classify qualitative quotes by country. In phase 1, three core themes were observed: (1) Structural, informational and systematic barriers influencing EAP accessibility and coverage; (2) Reluctance to use EAP services due to psychosocial and perceptual barriers; and (3) Service quality, scope and cultural relevance to those with multiple social identities. While most barriers were common across countries, US participants reported financial concerns exclusively. Comparatively, in the NLP analysis, financial accessibility and comprehensive support through diverse EAP offerings were important in classifying American quotes, while stigma, vulnerability, and fear of workplace judgement and perceived quality and cultural relevance of EAPs were important in classifying Canadian quotes. Although many barriers to using EAPs are shared, financial and perceptual differences exist between Canadian and American workers. EAPs may benefit from implementing country-specific strategies. This could include creating strategies reducing stigma and quality concerns in Canada, while addressing concerns about cost and alternative options in the United States. Further studies should focus on generalizability and explore sector-specific and longitudinal trends in EAP perceptions.
Assessing the antecedents behind after-hours work in teleworkers: a scoping review
Kishana Balakrishnar, Bao-Zhu Stephanie Long, Joyce Lo, Luke A Fiorini, Basem Gohar, Behdin Nowrouzi-Kia
Background
Since the start of the COVID-19 pandemic, telework arrangements have become increasingly prevalent, driven by benefits such as greater autonomy, reduced work-related stress, decreased commuting time and cost, and enhanced flexibility. Despite these advantages, teleworkers are more likely to engage in after-hours work, creating additional strain that may impact health and organizational outcomes.
Methods
A systematic search was conducted across seven online databases: Medline via OVID, Embase via OVID, APA PsycINFO via OVID, International Bibliography of Social Sciences via ProQuest, Sociological Abstracts via ProQuest, Business Source Premier via EBSCOhost, and CINAHL via EBSCOhost. Studies were included if they were empirical, peer-reviewed, published between 2010 and 2024, examined the antecedents of after-hours work, and focused on adults aged 18 to 65 engaged in telework. Descriptive thematic analysis was conducted to develop themes and sub-themes.
Results
Findings: A total of 17 studies were included in the review: 13 cross-sectional studies, three qualitative studies, and one longitudinal study. Using the Person–Environment–Occupation framework, three overarching themes were identified: (i) misalignment between personal capacities and occupational demands; (ii) environmental constraints that undermine healthy role balance; and (iii) occupational role strain in the context of remote work.
Conclusions
These findings may help to inform the development of targeted interventions that reduce cases of after-hours work among teleworkers and promote their overall health and well-being. Future research should examine these antecedents in non-Western contexts and explore the interplay between the individual, environmental, and occupational factors shaping after-hours work behaviors.
A qualitative study of lived experiences of underrepresented electrical workers using creative non-fiction
Zhiyang Shi, Donia Obeidat, Ali Bani-Fatemi, Aaron Howe, Behdin Nowrouzi-Kia
Objectives
Women, Indigenous peoples, racialized individuals, and persons with disabilities remain underrepresented in the electrical industry. This study explored the lived experience of underrepresented electrical workers related to their mental health and workplace integration.
Methods
A qualitative narrative design was employed. One-on-one interviews were conducted with eleven participants who self-identified as women, Indigenous peoples, racialized individuals, and/or persons with disabilities. Interview data were first analyzed using a narrative thematic approach and informed the development of creative non-fictional stories.
Results
Three stories were developed. Story 1 – “Asking for a ride: being a women electrician” illustrated the experiences of a woman apprentice who faced inadequate job site accommodations and sexism challenges in the workplace. Story 2 – “The lunch talk: Indigenous people and racialized individuals in the trade” highlighted the experiences of Indigenous and racialized participants who encountered language barriers and discriminatory comments. Story 3 – “Luke’s notes: living and working with disability” demonstrated the impacts of physical disability on the daily work of electrical workers, particularly in managing the physical demands and mental health strains.
Conclusions
Electrical workers from underrepresented groups experience persistent barriers to mental health and workplace integration, including a lack of accommodations, limited social support, and experiences of discrimination at the workplace. These individuals also reported challenges in seeking workplace support due to a “toughness” culture within the industry. Electrical employers should foster an inclusive organizational culture that prioritizes the health and psychosocial well-being of underrepresented workers.
Heat Exposure and Health Outcomes in Construction Workers: A Systematic Review and Meta-Analysis
Behdin Nowrouzi-Kia, Vijay Kumar Chattu, Thankam S. Sunil, Nancy Carnide, Heather Thomson, Raihana Premji, Aishvinigaa Sathananthan, Charlene Choi, Javier Mencia-Ledo
Climate change is becoming a recognized health concern in the scientific community, as heat exposure poses escalating health risks to outdoor occupational groups, particularly construction workers. Heat stress and climate change may lead to adverse physical health outcomes and reduced workability among construction workers. This systematic review and meta-analysis aimed to (1) examine the prevalence of physical health outcomes of construction workers in relation to heat exposure and (2) analyze the association between physical health outcomes of heat exposure and work performance by sex and age. Following the PRISMA guidelines and using a PICO framework, we conducted a comprehensive search across APA PsycINFO, MEDLINE, Embase, CINAHL, and Web of Science. Seventeen studies met our inclusion criteria. Outcomes were grouped into dehydration, heat-related illnesses (HRI), kidney function impairments, and heat-related deaths. Random-effects models were used for the meta-analysis, and subgroup analyses were performed using demographic variables. Pooled meta-analysis and heterogeneity statistics are only provided for the HRI outcome, as all other outcomes are only represented by single eligible studies. Dehydration demonstrated the highest single-study prevalence (0.97, 95% CI: 0.88, 1.00), contrasting with HRI pooled prevalence (0.40, 95% CI: 0.24, 0.58) and kidney function impairment single-study prevalence (0.17, 95% CI: 0.05, 0.39), which showed much lower estimates. High heterogeneity was present in the HRI symptoms category (I2 > 95%). Meta-regression revealed that males reported lower heat disorder prevalences in studies with both sexes (ß = −2.09, P = .049). Heat exposure significantly impairs the physical health of construction workers, particularly through dehydration and heat-related illnesses. Sex-responsive, psychological, and intervention-based studies are essential for protecting this vulnerable occupational group from accelerating climate change.
The impacts of climate change on occupational health and work among outdoor workers: A scoping review
Behdin Nowrouzi-Kia, Charlene Choi, Raihana Premji, Aishvinigaa Sathananthan, Kishana Balakrishnar, Alexia Haritos, Bao-Zhu Stephanie Long, Maryna Mazur, Ali-Bani Fatemi
Climate change has a significant impact on human health and productivity at work. Environmental changes, including extreme temperatures and natural disasters, contribute to psychological pressures and physical impairments which affect quality of life and well-being. This scoping review examines the effect of climate change on human health in occupational settings. A systematic search of MEDLINE, CINAHL, Embase, and PsycINFO identified empirical studies that analyzed the impacts of climate change on human health in relation to work. Eligible studies included employed individuals aged 18–65, peer-reviewed studies published between 2000 and 2024, and evidence linking climate change to occupational health outcomes. Studies underwent title, abstract, and full-text screening. The scoping review, registered with the Open Science Framework, includes 62 studies. Three overarching themes emerged: (1) climate change and mental health; (2) climate change and physical health; and (3) climate change and work. Research has demonstrated the association of psychological distress with extreme weather events, occupational stress, and anxiety among outdoor workers. Physical health risks associated with higher temperatures include chronic dehydration, heat-related illnesses, and other injuries. Climate change also negatively impacts work productivity, leading to increased labour shortages and subsequent economic losses. Climate change has complex effects on the physical and mental health of workers, with significant implications for productivity and safety in the workplace. Despite growing evidence, targeted interventions remain limited. Future studies should examine the long-term health consequences, develop standardized alleviation strategies, and implement policies to protect employees from climate-related occupational hazards.
Evaluating the Validity of the GM@W Survey: A Psychometric Study Across Gender and Industry
Javier Mencia-Ledo, Sana Siddiqui, Hong Ki Chloe Lau, Kishana Balakrishnar, André Luiz Fagundes Avila dos Santos, Ana Valentina Villarreal Galeano, Leyi Zhou, Michael Cooper, Gustavo S. Betini, Behdin Nowrouzi-Kia
Purpose
The National Workplace Psychological Health and Safety Standard (The Standard) recommends the use of a survey developed by Guarding Minds at Work (GM@W). However, its validity remains underexplored. This study has two objectives: (1) to evaluate the psychometric properties of the survey in assessing the Standard dimensions and (2) to examine validity across gender and industry.
Methods
A Confirmatory Factor Analysis (CFA) was conducted on data from the GM@W survey to evaluate the factor structure and validity of the 13 dimensions. Group comparisons by gender and occupational groups were assessed using t-tests and ANOVA tests.
Results
Across the 13 dimensions, most items demonstrated strong internal consistency and discriminant validity, with physical safety (r = 0.71) and organizational culture (r = 0.68) showing the highest internal consistency. While psychological competencies and physical safety were linked to positive mental health outcomes, challenges with workload management and balance remain prominent, especially for workers in healthcare and education. Group differences were observed, with women and workers in business, trades, and manufacturing reporting better psychosocial outcomes.
Discussion
While the GM@W tool demonstrated internal consistency and improved convergent validity compared to previous versions, significant model misfit was observed across all sectors. High latent correlations and frequent violations of the Fornell–Larcker criterion reveal substantial construct overlap and empirical redundancy. The findings suggest that while individual constructs are reliable, the 13-factor structure faces challenges in achieving empirical distinctiveness. Capturing the diverse psychosocial experiences of a national workforce within a single psychometric instrument remains a complex task.
Safeguarding the skilled trades: burnout, job satisfaction, and the risk of turnover in Ontario electricians
Maryam Shahzad, Javier Mencia Ledo, Mahdi Azarmi, Ali Bani-Fatemi, Behdin Nowrouzi-Kia
Skilled trades workers, including electricians, face unique occupational stressors and a persistent labour shortage that may contribute to burnout, job dissatisfaction, and heightened intention to leave (ITL). This cross-sectional study of 73 electricians aimed to assess the prevalence of burnout, job satisfaction, and ITL and to explore the relationships between these factors while accounting for sociodemographic and occupational characteristics. Burnout (measured using the Copenhagen Burnout Inventory), was prevalent (31.8%) but not independently associated with ITL. Higher job satisfaction (measured using an adapted NIOSH Generic Job Stress Questionnaire) was linked to lower ITL (OR = 0.58, 95% CI [0.34, 0.96]). Apprentice status significantly increased the odds of ITL (OR = 6.59, 95% CI [1.48, 38.47]). Findings suggest that job satisfaction is a protective factor against turnover intention, while apprentices are at a greater risk of ITL - underscoring the need for targeted retention and mental health strategies in the skilled trades.
Worker health and well-being in Ontario’s electrical sector: a quantitative study of occupational health outcomes
Donia Obeidat, Hong Ki Chloe Lau, Javier Mencia-Ledo, Sana Siddiqui, Avasa Sarawan, Zhiyang Shi, Raihana Premji, Aaron Howe, Ali Bani-Fatemi, Ali Asgary, Basem Gohar, Vijay Kumar Chattu, Geoffrey Maina, Thankam Sunil, Behdin Nowrouzi-Kia
Introduction: In Canada, Ontario’s shortage of electricians is linked to high physical demands and psychosocial stressors that may undermine worker well-being.
Methods: Using a Sustainable Development Goals (SDGs) informed lens, we conducted a cross-sectional online survey of self-employed electricians in Ontario (n = 188), assessing musculoskeletal symptoms (12-month), sleep quality, psychological distress, burnout (personal, work-related), and job satisfaction.
Results: Overall, 90.2% reported at least one musculoskeletal symptom in the past 12 months. Regression analyses revealed that sleep quality and years of experience significantly predicted psychological distress and burnout, with poorer sleep linked to higher personal and work-related burnout, greater psychological distress, and lower job satisfaction. More years of experience were associated with lower distress and burnout. Women reported higher psychological distress than men, highlighting inequality and discrimination in male-dominated trades. Apprentices experienced greater psychological distress [8.96 (SD = 8.29)] than non-apprentices [4.99 (SD = 6.59)], reflecting vulnerabilities associated with low wages, job insecurity, and a lack of support.
Discussion: These findings highlight the complex interplay of physical, psychological, and socio-structural factors in shaping electricians’ health. Targeted interventions are crucial for promoting sustainable and inclusive environments in the electrical industry.
Predicting burnout, anxiety and depression among Canadian healthcare professionals during the COVID-19 pandemic: a cross-sectional secondary analysis study
Kishana Balakrishnar, Bao-Zhu Stephanie Long, Raihana Premji, Charlene Choi, Aishvinigaa Sathananthan, Mandaakini Choppella, Maryna Mazur, Behdin Nowrouzi-Kia
This study aimed to identify the predictors of burnout, anxiety and depression among healthcare professionals during the COVID-19 pandemic. A secondary quantitative analysis of data from the Mental Health Research Canada (MHRC).
Setting Healthcare professionals across Canada during the COVID-19 pandemic.
Participants 1439 Canadian healthcare professionals. Data from MHRC, collected between April 2020 and January 2024, including sociodemographic factors and measures of burnout, anxiety and depression. In total, 1439 participants were included in the analysis. Women (OR: 2.25; 95% CI 1.46 to 3.48), younger workers (OR: 2.29; 95% CI 1.29 to 4.06) and mental health professionals (OR: 2.59; 95% CI 1.11 to 6.01) were more likely to experience burnout. Meanwhile, men (OR: 2.05; 95% CI 1.40 to 3.00), younger workers (OR: 8.58; 95% CI 4.12 to 17.86) and physicians (OR: 2.01; 95% CI 1.16 to 3.46) had an increased likelihood of being diagnosed with anxiety. Similar findings were obtained for depression, where men (OR: 1.74; 95% CI 1.18 to 2.56), young workers (OR: 5.22; 95% CI 2.68 to 10.18), physicians (OR: 2.11; 95% CI 1.22 to 3.64), visible minorities (OR: 2.29; 95% CI 1.55 to 3.38) and those with a physical impairment (OR: 4.79; 95% CI 2.55 to 8.97) were more likely to receive a diagnosis since the COVID-19 pandemic. These findings underscore the need for targeted clinical interventions among healthcare professionals during and beyond public health emergencies. Specifically, healthcare institutions should implement accessible mental health programmes, regular psychological assessments and workload management strategies for those who face increased vulnerabilities to mental health struggles.
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