Translation research in occupational safety and health: A proposed framework

An urgent call to address work-related psychosocial hazards and improve worker well-being

Work-related psychosocial hazards are on the verge of surpassing many other occupational hazards in their contribution to ill-health, injury, disability, direct and indirect costs, and impact on business and national productivity. The risks associated with exposure to psychosocial hazards at work are compounded by the increasing background prevalence of mental health disorders in the working-age population. The extensive and cumulative impacts of these exposures represent an alarming public health problem that merits immediate, increased attention. In this paper, we review the linkage between work-related psychosocial hazards and adverse effects, their economic burden, and interventions to prevent and control these hazards. We identify six crucial societal actions: (1) increase awareness of this critical issue through a comprehensive public campaign; (2) increase etiologic, intervention, and implementation research; (3) initiate or augment surveillance efforts; (4) increase translation of research findings into guidance for employers and workers; (5) increase the number and diversity of professionals skilled in preventing and addressing psychosocial hazards; and (6) develop a national regulatory or consensus standard to prevent and control work-related psychosocial hazards.

COMMunity of Practice And Safety Support for Navigating Pain (COMPASS-NP): study protocol for a randomized controlled trial with home care workers

BACKGROUND

Chronic pain is a prevalent and costly problem that often has occupational origins. Home care workers (HCWs) are at high risk for work-related injuries, pain, and disability. Current treatments for chronic pain emphasize medications, which are an inadequate stand-alone treatment and can produce significant adverse effects.

METHODS

In this translational study, we will adapt an established work-based injury prevention and health promotion program (COMmunity of Practice And Safety Support: COMPASS) to address the needs of HCWs experiencing chronic pain. COMPASS employs peer-led, scripted group meetings that include educational content, activities, goal setting, and structured social support. The translated intervention, named COMPASS for Navigating Pain (COMPASS-NP), will be delivered in an online group format. Safety protections will be strengthened through an ergonomic self-assessment and vouchers for purchasing ergonomic tools. Educational content will integrate a self-management approach to chronic pain using proven cognitive-behavioral therapy (CBT) principles. We will use a mixed-methods hybrid type 2 evaluation approach to assess effectiveness and implementation. A cluster-randomized waitlist control design will involve 14 groups of 10 HCWs (n = 140) recruited from Washington, Oregon, and Idaho. Half of the groups will be randomly selected to complete the intervention during the first 10 weeks, while the waitlist groups serve as controls. During weeks 10-20, the waitlist groups will complete the intervention while the original intervention groups complete a follow-up period without further intervention. Our primary hypothesis is that COMPASS-NP will reduce pain interference with work and life. Secondary outcomes include injury and pain prevention behaviors, pain severity, changes in medication use, risk for opioid misuse, well-being, physical activity, and sleep. Qualitative data, including phone interviews with group facilitators and organizational partners, will evaluate the implementation and guide dissemination.

DISCUSSION

The results will advance the use and knowledge of secondary prevention interventions such as ergonomic tools and cognitive behavior therapy, to reduce injury, pain, and disability and to encourage appropriate uses of analgesic medications among HCWs.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05492903. Registered on 08 August 2022.

Expanding the Focus of Occupational Safety and Health: Lessons from a Series of Linked Scientific Meetings

There is widespread recognition that the world of work is changing, and agreement is growing that the occupational safety and health (OSH) field must change to contribute to the protection of workers now and in the future. Discourse on the evolution of OSH has been active for many decades, but formalized support of an expanded focus for OSH has greatly increased over the past 20 years. Development of approaches such as the National Institute for Occupational Safety and Health (NIOSH)'s Total Worker Health® concept and the World Health Organization (WHO)'s Healthy Workplace Framework are concrete examples of how OSH can incorporate a new focus with a wider view. In 2019, NIOSH initiated a multi-year effort to explore an expanded focus for OSH. This paper is a report on the outputs of a three-year cooperative agreement between NIOSH and The University of Texas School of Public Health, which led to subject matter expert workshops in 2020 and an international conference of global interest groups in 2021. This article traces the background of these meetings and identifies and assesses the lessons learned. It also reviews ten thematic topics that emerged from the meetings: worker health inequalities; training new OSH professionals; future OSH research and practice; tools to measure well-being of workers; psychosocial hazards and adverse mental health effects; skilling, upskilling and improving job quality; socioeconomic influences; climate change; COVID-19 pandemic influences; and strategic foresight. Cross-cutting these themes is the need for systems and transdisciplinary thinking and operationalization of the concept of well-being to prepare the OSH field for the work of the future.

Methods to improve the translation of evidence-based interventions: A primer on dissemination and implementation science for occupational safety and health researchers and practitioners

Objective

A limited focus on dissemination and implementation (D&I) science has hindered the uptake of evidence-based interventions (EBIs) that reduce workplace morbidity and mortality. D&I science methods can be used in the occupational safety and health (OSH) field to advance the adoption, implementation, and sustainment of EBIs for complex workplaces. These approaches should be responsive to contextual factors, including the needs of partners and beneficiaries (such as employers, employees, and intermediaries).

Methods

By synthesizing seminal literature and texts and leveraging our collective knowledge as D&I science and/or OSH researchers, we developed a D&I science primer for OSH. First, we provide an overview of common D&I terminology and concepts. Second, we describe several key and evolving issues in D&I science: balancing adaptation with intervention fidelity and specifying implementation outcomes and strategies. Next, we review D&I theories, models, and frameworks and offer examples for applying these to OSH research. We also discuss widely used D&I research designs, methods, and measures. Finally, we discuss future directions for D&I science application to OSH and provide resources for further exploration.

Results

We compiled a D&I science primer for OSH appropriate for practitioners and evaluators, especially those newer to the field.

Conclusion

This article fills a gap in the OSH research by providing an overview of D&I science to enhance understanding of key concepts, issues, models, designs, methods and measures for the translation into practice of effective OSH interventions to advance the safety, health and well-being of workers.

Applying Translational Science Approaches to Protect Workers Exposed to Nanomaterials

Like nanotechnology, translational science is a relatively new and transdisciplinary field. Translational science in occupational safety and health (OSH) focuses on the process of taking scientific knowledge for the protection of workers from the lab to the field (i.e., the worksite/workplace) and back again. Translational science has been conceptualized as having multiple phases of research along a continuum, beyond scientific discovery (T₀), to efficacy (T₁), to effectiveness (T₂), to dissemination and implementation (D&I) (T₃), to outcomes and effectiveness research in populations (T₄). The translational research process applied to occupational exposure to nanomaterials might involve similar phases. This builds on basic and efficacy research (T₀ and T₁) in the areas of toxicology, epidemiology, industrial hygiene, medicine and engineering. In T₂, research and evidence syntheses and guidance and recommendations to protect workers may be developed and assessed for effectiveness. In T₃, emphasis is needed on D&I research to explore the multilevel barriers and facilitators to nanotechnology risk control information/research adoption, use, and sustainment in workplaces. D&I research for nanomaterial exposures should focus on assessing sources of information and evidence to be disseminated /implemented in complex and dynamic workplaces, how policy-makers and employers use this information in diverse contexts to protect workers, how stakeholders inform these critical processes, and what barriers impede and facilitate multilevel decision-making for the protection of nanotechnology workers. The T₄ phase focuses on how effective efforts to prevent occupational exposure to nanomaterials along the research continuum contribute to large-scale impact in terms of worker safety, health and wellbeing (T₄). Stakeholder input and engagement is critical to all stages of the translational research process. This paper will provide: (1) an illustration of the translational research continuum for occupational exposure to nanomaterials; and (2) a discussion of opportunities for applying D&I science to increase the effectiveness, uptake, integration, sustainability, and impact of interventions to protect the health and wellbeing of workers in the nanotechnology field.

Measuring societal impact of research—Developing and validating an impact instrument for occupational health and safety

Research funders and policymakers increasingly focus on societal benefits of their investments in research. Research institutions thus face increasing pressure to demonstrate their societal impact to prove their legitimacy and worth. To this end, research institutions need reliable, quantitative methods to measure societal impact. This article describes the development and test of an instrument to quantitatively measure societal impact of applied research at research institution and program levels. It demonstrates the successful validation of the instrument in the multi-disciplinary field of occupational health and safety. The instrument, the Societal Impact Instrument: Occupational Health and Safety Research (SII:OHSR), produces an aggregate measure of societal impact for the research institution as a whole and subscales for each research program. The SII:OHSR instrument is built on a process model of knowledge translation and exchange. It has been developed in the context of multi-disciplinary occupational health and safety research. The instrument is constructed as a generalized and context-independent tool that can be relocated to other research domains and languages. To the best of our knowledge, it is the first singular instrument that quantitatively measures societal impact. It is therefore highly pertinent for the research evaluation field.

Dissemination and Implementation Science Approaches for Occupational Safety and Health Research: Implications for Advancing Total Worker Health

Total Worker Health^® (TWH), an initiative of the U.S. National Institute for Occupational Safety and Health, is defined as policies, programs, and practices that integrate protection from work-related health and safety hazards by promoting efforts that advance worker well-being. Interventions that apply the TWH paradigm improve workplace health more rapidly than wellness programs alone. Evidence of the barriers and facilitators to the adoption, implementation, and long-term maintenance of TWH programs is limited. Dissemination and implementation (D&I) science, the study of methods and strategies for bridging the gap between public health research and practice, can help address these system-, setting-, and worker-level factors to increase the uptake, impact, and sustainment of TWH activities. The purpose of this paper is to draw upon a synthesis of existing D&I science literature to provide TWH researchers and practitioners with: (1) an overview of D&I science; (2) a plain language explanation of key concepts in D&I science; (3) a case study example of moving a TWH intervention down the research-to-practice pipeline; and (4) a discussion of future opportunities for conducting D&I science in complex and dynamic workplace settings to increase worker safety, health, and well-being.

An Exploratory, Qualitative Study of How Organizations Implement the Hierarchy of Controls Applied to Total Worker Health®

Understanding of how Total Worker Health^® (TWH) guidelines are implemented in employment organizations in the USA is not well understood. The purpose of this study is to explore how the principles of the Hierarchy of Controls Applied to NIOSH Total Worker Health (TWH HoC), have been implemented among organizations featured as Promising Practices for TWH between 2012–2019, with special focus on the work-related issues of fatigue, stress, sedentary work, and tobacco control. We also sought to identify benefits, obstacles, and lessons learned in the implementation of the TWH HoC. Eighteen organizations were identified to be included in the study. Using a qualitative cross-sectional design and purposive sampling, seven in-depth interviews were conducted with thirteen key informants. The Consolidated Framework for Implementation Research was used to guide the thematic analysis and interpretation of qualitative data. Four themes identified include recognition of the TWH approach and TWH HoC, implementation of the TWH HoC, barriers and facilitators in addressing specific work-related issues, and implementation climate primes benefits, obstacles, and lessons learned. The inner setting (i.e., culture, implementation climate, readiness for implementation) of organizations was a prominent determinant of the implementation of integrated worker safety, health, and well-being interventions.

Public Health Impacts of Underemployment and Unemployment in the United States: Exploring Perceptions, Gaps and Opportunities

BACKGROUND

Unemployment, underemployment, and the quality of work are national occupational health risk factors that drive critical national problems; however, to date, there have been no systematic efforts to document the public health impact of this situation.

METHODS

An environmental scan was conducted to explore the root causes and health impacts of underemployment and unemployment and highlight multilevel perspectives and factors in the landscape of underemployment and unemployment.

METHODS

included a review of gray literature and research literature, followed by key informant interviews with nine organizational representatives in employment research and policy, workforce development, and industry to assess perceived needs and gaps in practice.

RESULTS

Evidence highlights the complex nature of underemployment and unemployment, with multiple macro-level underlying drivers, including the changing nature of work, a dynamic labor market, inadequate enforcement of labor protection standards, declining unions, wage depression, and weak political will interacting with multiple social determinants of health. Empirical literature on unemployment and physical, mental, and psychological well-being, substance abuse, depression in young adults, and suicides is quite extensive; however, there are limited data on the impacts of underemployment on worker health and well-being. Additionally, organizations do not routinely consider health outcomes as they relate to their work in workforce or policy development.

DISCUSSION AND CONCLUSIONS

Several gaps in data and research will need to be addressed in order to assess the full magnitude of the public health burden of underemployment and unemployment. Public health needs to champion a research and practice agenda in partnership with multisector stakeholders to illuminate the role of employment quality and status in closing the gap on health inequities, and to integrate workforce health and well-being into labor and economic development agendas across government agencies and industry.

Risk management in occupational safety: A systematic mapping

BACKGROUND

Occupational safety risk management is a systemic process capable of promoting technical engineering solutions, considering a wide range of predictable, unexpected and subjective factors related to accident occurrences. In Brazil, the behavior of managers in relation to risk management tends to be reactive, and facilitates access to information for crucial practical and academic purposes when it comes to changing the attitude of managers, so that their actions become increasingly more proactive.

OBJECTIVE

To identify, classify, analyze, and discuss the existing literature related to the topic, produced from 2008 to 2020, besides contributing to a broader understanding of risk management in occupational safety.

METHODS

We did a systematic literature mapping. The research process was documented starting by the planning stage. Afterwards, the focus was on research conduction and information synthesis.

RESULTS

Knowledge systematization and stratification about OHS risk management through various perspectives to identify, analyze and manage risks in the workplace. Were identified 37 tools for identifying and analyzing risks, management-related practices and future research trends.

CONCLUSIONS

The set of tools and management practices identified can be used as a support for decision making in the selection process of tools and practices to reduce risks and improve occupational safety. Also, the results can help target future research.

Reaching "hard to reach" workers: Evaluating approaches to disseminate worker safety information via the Mexican consular network

Mexican immigrants suffer a disproportionately large number of work-related injuries and deaths given their share of the workforce. Barriers of language, culture, and mistrust are often cited as factors that complicate efforts to reach these workers with occupational safety and health (OSH) interventions. By partnering with the Mexican government and its consulate network in the United States, researchers from the National Institute for Occupational Safety and Health were able to assess the impact of four different information dissemination approaches (posters, passively distributed brochures, actively distributed brochures, and video kiosks) in Spanish in a five-phase study. Exit interviews conducted with Mexicans seeking consular services indicated that while nearly all respondents considered OSH to be of importance, significant differences in impact measures, such as noticing the materials and liking of content, were found when comparing the different approaches. Despite these differences, even the least effective approaches were noticed by large numbers of individuals and significantly increased their stated behavioral intentions regarding OSH. Considering all materials together, significantly more participants reported liking the materials (p < 0.001) than did not, learning something new (p < 0.01), trusting the information (p < 0.05), intending to seek out additional OSH information (p < 0.01), and intending to speak to their bosses about OSH (p < 0.05). These findings contribute to building an evidence base for moving research knowledge into practice, which is an essential, but often overlooked, element of occupational safety and health research, particularly among workers from underserved communities.

Identifying the "Active Ingredients" of a School-Based, Workplace Safety and Health Training Intervention

Young workers in many industrialized countries experience a higher rate of largely preventable occupation-related injuries compared with adults. Safety education and training are considered critical to the prevention of these incidents. This can be promoted by the dissemination and scale-out of an evidence-based, safety training programs in vocational education. The aim of this study was to identify the intervention core components that comprise the "active ingredients" of a safety training intervention for young workers and assess the impact on student outcomes of interest. Fidelity of implementation was operationalized using measures of adherence and quality of intervention delivery. For this study, data were collected through a school-based, cluster randomized trial conducted in 2015 in eight Finnish upper secondary-level vocational schools (n = 229 students in 22 groups, each with one teacher). Results indicate that the intervention core components (safety skills training, safety inoculation training, a positive atmosphere for safety learning, and active learning techniques) had differing associations with student outcomes. Adherence related to the acquisition of safety skills training was the strongest active ingredient in terms of positive effects. Furthermore, quality of delivery in terms of fostering positive learning atmosphere and utilizing active learning methods was associated especially with motivational outcomes. These findings indicate that different active ingredients complemented each other. Contrary to expectations, we found no statistically significant relationship between any of the core components and risk-taking attitudes. The current study advances prevention science by identifying the active ingredients of an evidence-based intervention, implemented in Finnish vocational school settings, that helps protect young workers from work-related morbidity and mortality.

A research impact model for work and health

Research organizations, governments and funding agencies are increasingly interested in the impact of research beyond academia. While a growing literature describes research impacts in healthcare and health services, little has focused on occupational health and safety research. This article describes a research impact model that has been in use for over a decade. The model was developed to track and describe the impact of research conducted by a mid-sized institute that focuses on work and health. Model development was informed by existing models, with the goal of contextualizing the institute's case studies describing three types of research impact: evidence of the diffusion of research; evidence of research informing decision-making; and evidence of societal impact. A logic model describes research actions and outcomes, as well as key audiences and knowledge transfer approaches. A unique element is its indication of the level of difficulty in determining types of impact. The model compares well with current research impact models developed or used in healthcare and health services research, and it has been useful in guiding a mid-sized research organization's process for tracking and describing the impact of its research. It may be useful to other small and mid-sized research organizations that focus on workplace health and safety.

The future of research on work, safety, health and wellbeing: A guiding conceptual framework

Work plays a central role in health. A conceptual model can help frame research priorities and questions to explore determinants of workers' safety, health, and wellbeing. A previous conceptual model focused on the workplace setting to emphasize the role of conditions of work in shaping workers' safety, health and wellbeing. These conditions of work include physical, organizational, and psychosocial factors. This manuscript presents and discusses an updated and expanded conceptual model, placing the workplace and the conditions of work within the broader context of socio-political-economic environments and consequent trends in employment and labor force patterns. Social, political and economic trends, such as growing reliance on technology, climate change, and globalization, have significant implications for workers' day-to-day experiences. These structural forces in turn shape employment and labor patterns, with implications for the availability and quality of jobs; the nature of relationships between employers and workers; and the benefits and protections available to workers. Understanding these patterns will be critical for anticipating the consequences of future changes in the conditions of work, and ultimately help inform decision-making around policies and practices intended to protect and promote worker safety, health, and wellbeing. This model provides a structure for anticipating research needs in response to the changing nature of work, including the formation of research priorities, the need for expanded research methods and measures, and attention to diverse populations of enterprises and workers. This approach anticipates changes in the way work is structured, managed, and experienced by workers and can effectively inform policies and practices needed to protect and promote worker safety, health and wellbeing.

Health Risk Calculator: An Online, Interactive Tool to Estimate how Health Impacts Workers' Compensation Claim Incidence and Cost

OBJECTIVE

The purpose of this paper is to describe and evaluate a web-based, educational Health Risk Calculator that communicates the value of investing in employee health and well-being for the prevention of work-related injuries, illnesses, and fatalities.

METHODS

We developed and evaluated the calculator following the RE-AIM framework. We assessed effectiveness via focus groups (n = 15) and a post-use survey (n = 33) and reach via website analytics.

RESULTS

We observed evidence for the calculator's usability, educational benefit, and encouragement of action to improve worker health and safety. Website analytics data demonstrated that we reached over 300 users equally in urban and rural areas within 3 months after launch.

CONCLUSION

We urge researchers to consider the ways in which they can communicate their empirical research findings to their key stakeholders and to evaluate their communication efforts.

Developing a Next-of-Kin Involvement Guide in Cancer Care-Results From a Consensus Process

Background

In hospital cancer care, there is no set standard for next-of-kin involvement in improving the quality of care and patient safety. There is therefore a growing need for tools and methods that can guide this complex area.

Objective

The aim of this study was to present the results from a consensus-based participatory process of designing a guide for next-of-kin involvement in hospital cancer care.

Method

A consensus process based on a modified Nominal group technique was applied with 20 stakeholder participants from 2 Norwegian university hospitals.

Result

The participants agreed on the 5 most important priorities for hospital cancer care services when involving next-of-kin. The results showed that next-of-kin stakeholders, when proactively involved, are important resources for the patient and healthcare professionals in terms of contribution to quality and safety in hospitals. Suggested means of involving next-of-kin were closer interaction with external support bodies, integration in clinical pathways, adjusted information, and training healthcare professionals.

Conclusion

In this study, we identified topics and elements to include in a next-of-kin involvement guide to support quality and safety in hospital cancer care. The study raises awareness of the complex area of next-of-kin involvement and contributes with theory development and knowledge translation in an involvement guide tailored for use by healthcare professionals and managers in everyday clinical practice.

Implications for Practice

Service providers can use the guide to formulate intentions and make decisions with suggestions and priorities or as a reflexive tool for organizational improvement.

The workplace health group: A case study of 20 years of multidisciplinary research

The Workplace Health Group (WHG) was established in 1998 to conduct research on worker health and safety and organizational effectiveness. This multidisciplinary team includes researchers with backgrounds in psychology, health promotion and behavior, and intervention design, implementation, and evaluation. The article begins with a brief history of the team, its guiding principles, and stages of team formation and development. This section provides examples of the roles, team composition, structure, processes, cognition, leadership, and climate played in the various stages of team development, as well as how they influenced team effectiveness. The WHG formed with functional diversity-variety in knowledge, skills, and abilities-in mind, and the impact of this diversity is discussed throughout the article. Illustrations of how the functional diversity of the WHG has led to real-world impact are provided. The article concludes with some lessons learned and recommendations for creating and sustaining multidisciplinary teams based on the WHG's 20 years of experience and the team science literature. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Cell Phone Ownership and Cellular Text/Email Capabilities Among Temporary and Payroll Construction Workers

Background: With high rates of temporary workers and a transient worker population, the U.S. construction workforce presents a challenge for long-term research and outreach activities. Increasing availability of affordable cell phone technologies may provide an opportunity for research follow-up among construction workers once they leave the worksite. Using pilot study survey data we characterize and examine the association of cell phone technology ownership and cellular text/email services among a non-probabilistic sample of payroll and temporary construction workers.

Methods: A cross-sectional study design was used to administer a one-time paper-based anonymous survey to construction workers working at construction sites in Florida, USA. The survey featured questions on sociodemographic characteristics, occupational history, cell phone technology ownership, and cellular text/email services capabilities.

Results: Among the 223 construction worker survey respondents, 31.4% identified as temporary workers and 68.6% were on payroll and 87.4% owned a cell phone. Construction workers who own a cell phone had greater than a high school education (28.9% vs. 25.0%; p = 0.019), made >$30,000/year (27.1% vs. 14.8%; p = 0.011), had same cell phone number for >1 year (74.4% vs. 40.7%; p = 0.001), and were employed as a payroll worker (71.0% vs. 50.0%; p = 0.037). Temporary construction workers compared to their payroll counterparts were significantly less likely to have email services on their cell phone [unadjusted-odds ratio 0.41 (95% CI: 0.17–0.97)].

Conclusion: Cell phone ownership and smartphone-enabled technologies such as email/texting capabilities are higher among payroll than temporary construction workers. Further research on frequency of cell phone use and types of email/texting services used by construction workers are needed.

Defining 'Integration' for Total Worker Health®: A New Proposal

The effects of work and the conditions of employment on health behaviors and intermediate health conditions have been demonstrated, to the extent that these relationships should be addressed in efforts to prevent chronic disease. However, conventional health promotion practice generally focuses on personal risk factors and individual behavior change. In an effort to find solutions to the myriad of health challenges faced by the American workforce, the U.S. National Institute for Occupational Safety and Health (NIOSH) established the Total Worker Health® (TWH) program. Originally organized around the paradigm of integrating traditional occupational safety and health protections with workplace health promotion, TWH has evolved to a broader emphasis on workplace programs for enhancing worker safety, health, and well-being. Among the research programs and approaches developed by investigators at NIOSH Centers of Excellence for TWH and elsewhere, definitions of 'integration' in workplace interventions vary widely. There is no consensus about which organizational or individual outcomes are the most salient, how much to emphasize organizational contexts of work, or which program elements are necessary in order to qualify as 'Total Worker Health'. Agreement about the dimensions of integration would facilitate comparison of programs and interventions which are self-defined as TWH, although diverse in content. The specific criteria needed to define integration should be unique to that concept-i.e. distinct from and additive to conventional criteria for predicting or evaluating the success of a workplace health program. We propose a set of four TWH-specific metrics for integrated interventions that address both program content and process: (i) coordination and interaction of workplace programs across domains; (ii) assessment of both work and non-work exposures; (iii) emphasis on interventions to make the workplace more health-promoting; and (iv) participatory engagement of workers in pivotal ways during intervention prioritization and planning to develop self-efficacy in addressing root causes, skill transfer, building program ownership, empowerment, and continuous improvement. Thus we find that integration requires organizational change, both to engage two managerial functions with different goals, legal responsibilities, and (often) internal incentives & resources, and also to orient the organization toward salutogenesis. Examples from research activity within the Center for the Promotion of Health in the New England Workplace illustrate how these criteria have been applied in practice.

Components of an Occupational Safety and Health Communication Research Strategy for Small- and Medium-Sized Enterprises

The majority of the global labor force works in firms with fewer than 50 employees; firms with fewer than 250 employees make up 99% of workplaces. Even so, the lack of extensive or comprehensive research has failed to focus on occupational safety and health communication to these small- and medium-sized enterprises (SMEs). Given that the magnitude of all occupational safety and health (OSH) morbidity, mortality, and injury disproportionately occurs in businesses with fewer than 250 employees, efforts to communicate with employers to engage in preventative occupational safety and health efforts merit attention. This article provides an overview of important components that should be considered in developing an occupational safety and health (OSH) communication research strategy targeting SMEs. Such a strategy should raise awareness about the diversity and complexity of SMEs and the challenges of targeting OSH communication toward this diverse group. Companies of differing sizes (e.g. 5, 50, 500 employees) likely require differing communication approaches. Communication strategies will benefit from deconstructing the term 'small business' into smaller, more homogenous categories that might require approaches. Theory-based research assessing barriers, message content, channels, reach, reception, motivation, and intention to act serve as the foundation for developing a comprehensive research framework. Attention to this type of research by investigators is warranted and should be encouraged and supported. There would also be value in developing national and international strategies for research on communication with small businesses.

Identifying Safety Training Resource Needs in the Cattle Feeding Industry in the Midwestern United States

Cattle feedyards are a high-risk environment. They are characterized by high rates of occupational injuries and illnesses. As such, there is a clear need to address the health and safety of cattle feedyard workers. Therefore, the purpose of this cross-sectional study was to explore safety training practices and preferences in the cattle feeding industry. A survey of feedyard managers, feedyard safety trainers, and feedyard operators was conducted (n = 28). We found that only half of respondents had dedicated safety personnel; however, there was interest in a safety training program, conducted through short hands-on and in-person methods with materials available in English and Spanish. The majority of participants were also interested in a feedyard safety certification program. Participants reaffirmed the importance of partnering with industry and other stakeholders when conducting these types of programs. The results of this Phase 1-type translational research study will be used to guide the development of feedyard safety trainings and a corresponding recognition program for feedyards and feedyard workers as part of the “Improving Safety and Health of Cattle Feedyard Workers” project.

Total Worker Health® 2014⁻2018: The Novel Approach to Worker Safety, Health, and Well-Being Evolves

Background: The objective of this article is to provide an overview of and update on the Office for Total Worker Health^® (TWH) program of the Centers for Disease Control and Prevention’s National Institute for Occupational Safety and Health (CDC/NIOSH). Methods: This article describes the evolution of the TWH program from 2014 to 2018 and future steps and directions. Results: The TWH framework is defined as policies, programs, and practices that integrate protection from work-related safety and health hazards with promotion of injury and illness prevention efforts to advance worker well-being. Conclusions: The CDC/NIOSH TWH program continues to evolve in order to respond to demands for research, practice, policy, and capacity building information and solutions to the safety, health, and well-being challenges that workers and their employers face.

Research Methodologies for Total Worker Health®: Proceedings From a Workshop

OBJECTIVE

There is growing interest in the NIOSH Total Worker Health program, specifically in the process of designing and implementing safer, health-promoting work and workplaces. A Total Worker Health (TWH) Research Methodology Workshop was convened to discuss research methods and future needs.

METHODS

Twenty-six experts in occupational safety and health and related fields reviewed and discussed current methodological and measurement issues and those showing promise.

RESULTS

TWH intervention studies face the same challenges as other workplace intervention studies and some unique ones. Examples are provided of different approaches and their applications to TWH intervention studies, and desired developments in the TWH literature.

CONCLUSIONS

This report discusses and outlines principles important to building the TWH intervention research base. Rigorous, valid methodologic, and measurement approaches are needed for TWH intervention as well as for basic/etiologic, translational, and surveillance research.

Conference Summary Understanding Small Enterprises Conference, 25-27 October 2017

Objectives

The specific objectives of the 2017 Understanding Small Enterprises Conference were to: (i) identify successful strategies for overcoming occupational safety and health (OS&H) barriers in small and medium-sized enterprises (SMEs); (ii) disseminate best practices to research and business communities; (iii) build collaborations between different stakeholders including researchers, insurers, small enterprises, government agencies; and (iv) better inform OS&H research relevant to SMEs.

Methods

A two and a half day international conference was organized, building upon three previously successful iterations. This conference brought together researchers, practitioners, and other stakeholders from 16 countries to share best practices and emerging strategies for improving OS&H in SMEs.

Findings

Cross-cutting themes that emerged at the conference centered around: 1) stakeholder and intermediary involvement; 2) what occupational health and safety looks like across different industries; 3) intervention programs (tools and resources); 4) precarious and vulnerable work and the informal sector; and 5) Total Worker Health® in SMEs.

Conclusion

A number of innovative initiatives were shared at the conference. Researchers must build collaborations involving a variety of stakeholder groups to ensure that OS&H solutions are successful in SMEs. Future OS&H research should continue to build upon the successful work of the 2017 Understanding Small Enterprises Conference.

Small business Total Worker Health: A conceptual and methodological approach to facilitating organizational change

Nearly half of Americans are employed by small businesses, and future projections suggest that the number of those employed by small businesses will rise. Despite this, there is relatively little small business intervention research on the integration of health protection and health promotion, known as Total Worker Health® (TWH). We first discuss the importance of studying small businesses in TWH research and practice. Second, we describe an example of a small business TWH intervention, Health Links™ plus TWH owner/senior manager leadership training, that we are evaluating via the Small+Safe+Well (SSWell) study. Key features of the intervention and the SSWell study include attention to multi-level influences on worker health, safety and well-being; organizational change; and dissemination and implementation science strategies via the RE-AIM model. We offer several considerations for future small business TWH research and practice both in terms of the small business context as well as intervention development and evaluation. Our goal is to provide TWH researchers and practitioners with a framework and an example of how to approach small business TWH interventions. Ultimately, through the SSWell study, we aim to provide small businesses with strong evidence to support the use of TWH strategies that are practical, effective and sustainable.