Harvard T.H. Chan School of Public Health

The Thriving from Work User Manual provides a definition for "Thriving from Work" and why it is important to measure, the process used to develop the Thriving from Work conceptual framework and questionnaires, the full English versions of the two questionnaires including the short-form and the long-form, and their practical applications.

The Thriving from Work Questionnaire Frequently Asked Questions document describes thriving from work and the Thriving from Work Questionnaires, as well as what these instruments measure and why measuring thriving from work is important.

The Thriving from Work Questionnaire has been translated from English to Spanish and validated in populations of workers in Peru and Mexico.

The Thriving from Work Questionnaire Scoring Guide accompanies the Thriving from Work Questionnaire User Manual and was developed to assist both researchers and practitioners in scoring the Thriving from Work Questionnaire using some common approaches. There are a variety of scoring options one may use with the Thriving from Work Questionnaire; the pros and cons of different scoring approaches depend on the goals of the use of the instrument and the context in which the data are collected.

"Implementing an Integrated Approach: Weaving Employee Health, Safety, and Well-Being into the Fabric of Your Organization" is a detailed step-by-step evidence-based approach to implementing an integrated approach to worker safety, health, and well-being at an organization. With real-world examples, it demonstrates how to inspire key worksite stakeholders to support and participate in an integrated approach; identify goals and objectives for an integrated initiative; target working conditions meaningful to workers and employers; implement policies and practices that create and sustain positive working conditions; and evaluate and continually improve efforts to enhance worker safety, health, and well-being. These guidelines are available in English and in Spanish, with a stand-alone Executive Summary available in English.

"Implementing an Integrated Approach: Weaving Employee Health, Safety, and Well-Being into the Fabric of Your Organization" is a detailed step-by-step evidence-based approach to implementing an integrated approach to worker safety, health, and well-being at an organization. With real-world examples, it demonstrates how to inspire key worksite stakeholders to support and participate in an integrated approach; identify goals and objectives for an integrated initiative; target working conditions meaningful to workers and employers; implement policies and practices that create and sustain positive working conditions; and evaluate and continually improve efforts to enhance worker safety, health, and well-being. These guidelines are available in English and in Spanish, with a stand-alone Executive Summary available in English.

The Thriving from Work Questionnaire has been translated from English to German and validated in populations of workers in Germany.

Introduction: Iron-folic acid (IFA) and calcium supplementation are recommended during pregnancy; however, calcium may inhibit iron absorption. While recent trials have shown daily low-dose 500 mg calcium supplementation to be noninferior to the recommended high-dose 1500 mg regimen for prevention of preeclampsia, its effects on maternal anaemia and iron status remain unclear. Methods: We conducted two individually randomized, non-inferiority trials in India and Tanzania (N=11,000 each) comparing daily 500 mg to 1500 mg calcium supplementation during pregnancy. All participants received standard IFA (60 mg iron) and were counselled to take calcium supplements several hours apart from the IFA. All participants had haemoglobin measured at baseline and at 32 weeks of gestation, while a random subset of participants had ferritin quantified at the same time points. Using an intention-to-treat approach, we assessed effects of 500 mg compared to 1500 mg calcium supplementation on mean haemoglobin and inflammation-adjusted serum ferritin concentrations using generalised linear models, and on anaemia, and iron deficiency anaemia using log-binomial models. Results: Third-trimester haemoglobin and serum ferritin were measured in 8,953 and 1,336 participants in India, respectively. In Tanzania, 8,496 participants had haemoglobin and 882 had ferritin assessed. In both trials, there was no difference between 500 and 1500 mg calcium supplementation on third-trimester haemoglobin [India: mean difference (MD) 0.01 (95% confidence intervals (CIs): -0.03, 0.04); Tanzania: MD -0.02 (95% CIs: -0.07, 0.03)], anaemia [India: relative risk (RR) 1.01 (95% CIs: 0.95, 1.07); Tanzania: RR 1.00 (95% CIs: 0.96, 1.05)], or iron deficiency anaemia [India: RR 1.20 (95% CIs: 0.93, 1.57); Tanzania: RR 0.94 (95% CIs: 0.77, 1.15)]. Conclusion: Low and high-dose calcium supplementation showed no differences in third-trimester hematologic outcomes. Future studies should assess co-administering or combining calcium and IFA into a single tablet on adherence and maternal iron status.

Objective: Hypertensive disorders of pregnancy (HDP) cause 10-15% of maternal deaths globally. Calcium-supplementation can prevent preeclampsia in low- and middle-income countries (LMICs) with low dietary calcium intake, but data on acceptability and adherence to high-dose supplementation (≥1000 mg/d) in public health programs is limited. Setting: We evaluated the acceptability and adherence to routine antenatal calcium-supplementation among pregnant women and healthcare providers in urban Bangalore. Design: An open-label study of 1000mg/d calcium-supplementation was conducted among 275 pregnant women, enrolled ≤20 weeks of gestation attending routine-antenatal-care (ANC), and followed-up until delivery. A mixed-methods approach was used to assess perception, acceptability, and factors influencing calcium-supplementation. Focus group discussions (FGDs) were conducted with pregnant women and healthcare workers. Result: After the first-month of taking calcium, post recruitment, 13.4% reported to have disliked the calcium supplement and this decreased to 7.9% in third trimester. Overall, 157 (57.3%) had ≥75% adherence to the calcium-supplementation regimen. Disliking calcium pills at first ANC follow-up (OR:3.5, 95%; CI:1.58–7.57) or the third trimester visit (OR:7.5, 95%; CI:2.38–23.40) was significantly associated with <75% adherence to calcium-supplementation. FGDs in third trimester identified enablers such as self-perceived benefits, family, and healthcare worker support, while barriers included preference for private clinics (which did not provide free-calcium-supplements), the size and number of calcium tablets/day. Conclusion: Achieving high adherence to calcium-supplementation was challenging during pregnancy. Interventions and strategies supporting pregnant women, while considering the roles of families and healthcare systems, should be assessed to enhance the effective implementation of calcium-supplementation during pregnancy.