A model for design of tailored working environment intervention programmes for small enterprises

Benefits and functionality of an interorganisational workplace health management network - insights from the companies' perspective

Introduction

Workplace health management (WHM) is a worthwhile investment for companies. Nevertheless, the implementation of health-promoting interventions remains limited, especially in small and medium-sized enterprises. Interorganisational networks could be a promising way to raise awareness of the advantages of implementing WHM. Therefore, the aim of this study is to analyse the perceived functionality and benefits of a regional WHM network from companies' perspective and to present initial results on this specific topic.

Methods

An explorative qualitative case study was conducted analysing ERZgesund, a WHM network in a rural region in Germany. Twenty-two companies that participated in the network were interviewed about their experiences and perceived advantages and disadvantages participating in the WHM network ERZgesund.

Results

The findings show that the network has raised awareness about WHM among the companies, provides opportunities for exchange of knowledge and experiences, and generates or strengthens collaboration. The positive effects were enhanced by the network's structure, such as regionality and a direct contact person. Nevertheless, some companies stated that they would welcome a higher level of participation and transparency.

Conclusion

Overall, it becomes clear that a WHM network can be a valuable tool to emphasize the relevance of WHM to companies. Therefore, further studies should validate and intensify the research on WHM networks to ensure a long-term benefit from the network.

Effectiveness of Occupational Safety and Health interventions: a long way to go

Background

Occupational Safety and Health (OSH) has become an area of increasing concern for organizations and institutions. As it evolves, it has gradually posed ongoing challenges, becoming more complex, for organizations. Consequently, more comprehensive studies are required to advance academic and institutional research. From this perspective, this study aims to gather research contributions on the effectiveness of existing interventions for OSH improvement and identify areas for further exploration.

Methods

According to the nature of scientific literature, the overall process of a literature review was investigated following an integrative approach, which involved searching for, selecting, and analyzing various literature in a creative and integrated manner, without a predefined structure.

Results

The analysis suggests that there is room for improvement in understanding the effectiveness of OSH interventions and more concrete guidance is still desirable. Based on the literature, some research areas for future developments in OSH interventions are identified. One potential area to explore further is fostering human-centered technological development and a more conscious network of stakeholders, with higher coordination, shared knowledge, and open communication.

Implications

Focusing on the proposed directions will support scholars and practitioners in pursuing continuous OSH improvement through more effective and well-grounded workplace interventions and encourage organizations to be proactive in daily OSH management.

Management Approaches to Health and Safety at Work during Prevention Intervention Planning

This work deals with a systematic review of the literature data concerning the theme of integrated approaches to occupational health and safety management, with particular reference to the programming of assistance plans, which guide companies' organizational choices by also addressing the principles of Total Worker Health. In the current regulatory framework on this issue, the UNI ISO 45001: 2018 standard "Occupational health and safety management systems-Requirements and guidance for use" (published on 12 March 2018)" assumes relevance, defining dynamic approaches to occupational health and safety management systems-paying particular attention to external contextual factors that may influence corporate organizational decisions. The adoption of these systems is not mandatory but allows companies to fulfill their duties in terms of health and safety at work through an organizational approach aimed at the awareness, involvement, and participation of all subjects of the company prevention system, progressing past the phase of mere technological and prescriptive approaches towards a holistic vision of prevention that places the person at the center of preventive actions. In this context, the role of institutional networks and socio-economic partnerships assumes particular importance via the activation of territorial assistance interventions to support companies aimed at improving risk management levels. To this end, the importance of verifying the effectiveness of assistance interventions emerges from the scientific debate using indicators such as quantitative indicators aimed at measuring the performance of all phases of an intervention, with particular attention to their effects in terms of the improved solutions developed.

Grounded theory-based analysis of occupational health and safety management modes in supply chain by core enterprises --evidence from China

The implementation of occupational health and safety management in the supply chain by core enterprises is a significant step towards improving the working conditions of their suppliers. To guide core enterprises to adopt active and effective management modes, it is crucial to identify the characteristics of different management modes and classify them accordingly. This paper employs the grounded theory method to conduct an in-depth analysis of occupational health and safety management modes within the supply chain of core enterprises. This research mainly adopts semi-structured interview method. A total of 16 person-times are interviewed, and 210,000 words of in-depth interview scripts are obtained. After three coding process of the grounded theory，the evolution model of occupational health and safety management modes in supply chain by core enterprises was established. The research results indicate that core enterprises currently employ three modes of occupational health and safety management for their suppliers: defensive mode, passive mode, and strategic mode. Different modes have distinct characteristics in four dimensions of cognition, motivation, strategy and result. This research may provide strategic guidelines for core enterprises to evolve from the defensive mode to the strategic mode.

Intermediary Perspectives on Total Worker Health in Small Businesses

The future of work will include not only more small business employment, but also a need for greater consideration of more holistic approaches to addressing worker well-being. Previous research has suggested smaller firms need external assistance to add new or improve existing workplace health and safety activities. A Total Worker Health^® (TWH) approach is potentially appealing to small employers as it is intended to identify and support comprehensive practices and policies that take into account the work environment (both physical and organizational) while also addressing the personal health risks of individuals, thus being more effective in preventing disease and promoting health and safety than each approach taken separately. NIOSH researchers applied the NIOSH Small Business Intervention Diffusion Model to conduct parallel community-based TWH activities in two geographically distinct communities in a large metropolitan area. Data were collected from intermediary organizations that work with or serve small businesses about their perceptions of the TWH approach as a potential service for them to offer small firms. Intermediary organizations engaged in implementation of TWH approaches with small businesses in the respective geographic areas for approximately one year. Results indicated intermediary organizations find value in providing TWH assistance to small employers, but several challenges for intermediaries implementing TWH among small employers remain.

A mixed-method approach to tailor the implementation of a participatory Total Worker Health® program

Purpose –

Total Worker Health^® (TWH) programs, which represent a holistic approach for advancing worker safety, health and well-being, require an employer to adapt programmatic coordination and employee involvement in program design and delivery. Organizational readiness for such measures requires competencies in leadership, communication, subject expertise and worker participation. In the absence of documented methods for TWH readiness assessment, the authors developed a process to prospectively identify implementation facilitators and barriers that may be used to strengthen organizational competencies and optimize the organizational "fit" in advance.

Design/methodology/approach –

The mixed-method baseline assessment instruments comprised an online organizational readiness survey and a key leader interview; these were administered with key organizational and labor leaders in five US healthcare facilities. Findings about organizational resources, skills available and potential implementation barriers were summarized in a stakeholder feedback report and used to strengthen readiness and tailor implementation to the organizational context.

Findings –

The research team was able to leverage organizational strengths such as leaders' commitment and willingness to address nontraditional safety topics to establish new worker-led design teams. Information about program barriers (staff time and communication) enabled the research team to respond with proactive tailoring strategies such as training on participant roles, extending team recruitment time and providing program communication tools and coaching.

Originality/value –

A new method has been developed for prospective organizational readiness assessment to implement a participatory TWH program. The authors illustrate its ability to identify relevant organizational features to guide institutional preparation and tailor program implementation.

Barriers and drivers of psychosocial risk assessments in German micro and small-sized enterprises: a qualitative study with owners and managers

BACKGROUND

The negative effect of unfavorable working conditions and long-term work stress on health has been demonstrated in previous research. To address these challenges, systematic approaches such as psychosocial risk assessments (PRA) have been developed in many countries worldwide. Despite legal obligations, psychosocial risk assessments are rarely carried out in micro and small-sized enterprises (MSE). Even though those enterprises constitute a large proportion of the general workforce, this area remains largely untouched by research. In order to enable starting points for a greater dissemination in organizational practice, the present study explores barriers and drivers of psychosocial risk assessments in micro and small-sized enterprises.

METHODS

A total of 18 owners and managers from 15 micro and small-sized enterprises in North-Rhine Westphalia, Germany, were interviewed. The interviews were audio-recorded, transcribed, and analyzed. A qualitative approach was applied: Content analysis was used to analyze the data, using deductive as well as inductive coding techniques.

RESULTS

The following barriers emerged from the interviews: Negative PRA image, stigmatization of mental health, lacking acceptance of employees, fear of excessive authority interference, ignorance of PRA, not understanding the necessity, inappropriate approach, and limited resources. The identified drivers were: Easy access to PRA material, external support from experts, renaming the term "workplace risk assessment", understanding content and benefit of PRA, simplify and revise PRA process, and noticeable consequences of PRA execution and non-execution. The results are comparable with those in larger companies. They emphasize the importance of mental health education, improving the process of psychosocial risk assessments, and the ongoing support in overcoming limited financial as well as human resources.

CONCLUSIONS

To improve implementation of PRA in organizational practice, a simplification of the process is proposed, accompanied by information campaigns and an improvement in the health literacy of owners and managers of MSE. In view of the results, the full revision of the PRA approach should also be considered.

Factors influencing the implementation of workplace health promotion in companies in rural areas

Purpose

Workplace health promotion (WHP) is becoming increasingly important due to the ageing workforce and a shortage of skilled workers. Nevertheless, too few companies have reacted to the demographic change and introduced health-promoting measures. This paper aims to identify which factors influence the implementation of WHP, especially in small and medium-sized enterprises (SMEs) in rural areas.

Design/methodology/approach

253 companies in a rural area in the federal state of Saxony (Germany) were surveyed using a standardised questionnaire via a computer-assisted telephone interview. Bivariate analyses and logistic regression models were carried out. The focus was on the relationship between the status of WHP and the size of the company, pressure of demographic change, health-related attitude and organisational capacity factors.

Findings

It was shown that, in addition to the control variables company size and pressure of the shortage of skilled workers, a company's attitude regarding health promotion, financial capacity and planning and development capacity has a relevant influence on the status of WHP.

Practical implications

Based on the results, targeted measures can be developed and converted to implement WHP, particularly in SMEs in rural regions. The focus should be on sensitisation, knowledge transfer and capacity development.

Originality/value

The present paper reveals the relationship between company size, pressure of demographic change, health-related attitude and organisational capacities regarding the status of health-promoting measures in SMEs in a rural region.

NOSACQ-50 for Safety Climate Assessment in Agricultural Activities: A Case Study in Central Italy

Safety climate assessment has been recognized as a powerful tool to bring to light workers' perceptions related to safety practices, attitudes and behaviors at the workplace. Accordingly, its investigation can provide useful information about safety problems within a company before accidents occur. In literature, numerous studies can be found investigating safety climates in different types of industry. However, safety climate assessment in agricultural activities is addressed scarcely, even though agriculture represents a very hazardous sector. To reduce this gap, the present study proposes an investigation of safety climate among farmers by means of the Nordic Safety Climate Questionnaire (NOSACQ-50). The results of the survey brought to light a low level of safety perception of the interviewed sample, especially as concerns safety commitment and risk-taking attitudes. In particular, a different attitude toward safety issues has been registered depending on both the position and gender of the interviewed farmers. Overall, the output of this cross-sectional analysis adds to the current literature by expanding knowledge of safety climate among farmers, representing a baseline for further investigations based on human-centered approaches to enhance safety in agriculture and consequently social and workplace aspects of sustainable agricultural systems.

The effect of perceived organizational support for safety and organizational commitment on employee safety behavior: a meta-analysis

Recently, the significance of organizational support and commitment in workplace safety has gained much recognition. The improvement of individual safety behavior needs more convincing and effective evidence. This study constructed a comprehensive theoretical model and used meta-analysis to examine the relationships between perceived organizational support for safety, organizational commitment and employee safety behavior. Support was found for the study's hypothesis that both perceived organizational support for safety and organizational commitment have a positive association with employee safety behavior, with the latter demonstrating the stronger relationship. However, organizational commitment was not mediated by perceived organizational support for safety and employee safety behavior. Results show that the safety behavior of employees in general industries and developed regions is more vulnerable to perceived organizational support for safety and organizational commitment than that in high-risk industries and developing regions. The implications of the findings and suggestions for further research are discussed.

Occupational safety in the construction industry

BACKGROUND

The paper is a research review focusing on occupational safety in the construction industry.

OBJECTIVE

The purpose is to present research that highlights the areas of occupational safety and risks and to identify areas where research is lacking.

METHODS

146 articles from scientific journals, mainly covering the construction industry in Europe, Canada, USA, Australia and Japan have been studied. The findings are presented under 11 categories: accident statistics; individual factors; legislation and regulations; ethical considerations; risk management; leadership, management, organization; competence; safety design; cost-benefit calculations; programs and models; and technical solutions.

RESULTS

The research is dominated by initiatives from researchers and government authorities, while the construction industry only appears as the object for the research. There is a scarcity of research on integrated systems encompassing subcontractors, as well as a lack of research with sociological perspectives on accidents. Furthermore, only a few studies have applied a gender perspective on safety in construction, i.e. there is a need of further research in this particular area.

CONCLUSIONS

A range of initiatives have been taken to increase safety in the construction industry and the initiatives are mainly reported to be successful. There are some cultural differences, but basically researchers present similar results regardless of country.

Occupational accidents in Swedish construction trades

The purpose of this study is to analyze accidents occurring in the Swedish construction industry, focusing specifically on the situation in the individual trades. The article includes all occupational accidents with at least 1 day of absence from work that were reported to the Swedish Social Insurance Agency for the year 2016. The results, focusing on accident cause, injured body parts as well as accidents per weekday, month and age, show that although the trades share commonalities regarding occupational accidents, a number of trade-specific problem areas stand out. With this in mind, conclusions are drawn regarding the situation in each respective trade and suggestions are made for future studies focusing on accidents in construction industry trades.

Effects of organizational safety on employees' proactivity safety behaviors and occupational health and safety management systems in Chinese high-risk small-scale enterprises

Based on the characteristics of small-scale enterprises, the improvement of occupational health and safety management systems (OHS MS) needs an effective intervention. This study proposed a structural equation model and examined the relationships of perceived organization support for safety (POSS), person-organization safety fit (POSF) and proactivity safety behaviors with safety management, safety procedures and safety hazards identification. Data were collected from 503 employees of 105 Chinese high-risk small-scale enterprises over 6 months. The results showed that both POSS and POSF were positively related to improvement in safety management, safety procedures and safety hazards identification through proactivity safety behaviors. Our findings provide a new perspective on organizational safety for improving OHS MS for small-scale enterprises and extend the application of proactivity safety behaviors.

Analysis of Managing Safety in Small Enterprises: Dual-Effects of Employee Prosocial Safety Behavior and Government Inspection

This paper aims to promote a national and international occupational health and safety (OHS) intervention for small and medium enterprises (SMEs) within internal and external resources. Based on the characteristics of small SME management, the work environment and occupational health may be positively affected by the dual-effects of employees and government. Evolutionary game theory is utilized to identify relevant interactions among the government, small enterprises, and employees. Furthermore, dynamic simulations of the evolutionary game model are used to explore stability strategies and to identify modes of equilibrium.

Quality and reporting standards, resources, training materials and information for realist evaluation: the RAMESES II project

Background

Many of the problems confronting policy- and decision-makers, evaluators and researchers today are complex, as are the interventions designed to tackle them. Their success depends both on individuals’ responses and on the wider context of people’s lives. Realist evaluation tries to make sense of these complex interventions. It is a form of theory-driven evaluation, based on realist philosophy, that aims to understand why these complex interventions work, how, for whom, in what context and to what extent.

Objectives

Our objectives were to develop (a) quality standards, (b) reporting standards, (c) resources and training materials, (d) information and resources for patients and other lay participants and (e) to build research capacity among those interested in realist evaluation.

Methods

To develop the quality and reporting standards, we undertook a thematic review of the literature, supplemented by our content expertise and feedback from presentations and workshops. We synthesised findings into briefing materials for realist evaluations for the Delphi panel (a structured method using experts to develop consensus). To develop our resources and training materials, we drew on our experience in developing and delivering education materials, feedback from the Delphi panel, the RAMESES JISCMail e-mail list, training workshops and feedback from training sessions. To develop information and resources for patients and other lay participants in realist evaluation, we convened a group consisting of patients and the public. We built research capacity by running workshops and training sessions.

Results

Our literature review identified 152 realist evaluations, and when 37 of these had been analysed we were able to develop our briefing materials for the Delphi panel. The Delphi panel comprised 35 members from 27 organisations across six countries and five disciplines. Within three rounds, the panels had reached a consensus on 20 key reporting standards. The quality standards consist of eight criteria for realist evaluations. We developed resources and training materials for 15 theoretical and methodological topics. All resources are available online (www.ramesesproject.org). We provided methodological support to 17 projects and presentations or workshops to help build research capacity in realist evaluations to 29 organisations. Finally, we produced a generic patient information leaflet for lay participants in realist evaluations.

Limitations

Our project had ambitious goals that created a substantial workload, leading to the need to prioritise objectives. For example, we truncated the literature review and focused on standards and training material development.

Conclusions

Although realist evaluation holds much promise, misunderstandings and misapplications of it are common. We hope that our project’s outputs and activities will help to address these problems. Our resources are the start of an iterative journey of refinement and development of better resources for realist evaluations. The RAMESES II project seeks not to produce the last word on these issues, but to capture current expertise and establish an agreed state of the science. Much methodological development is needed in realist evaluation but this can take place only if there is a sufficient pool of highly skilled realist evaluators. Capacity building is the next key step in realist evaluation.

Funding

The National Institute for Health Research Health Services and Delivery Research programme.

Firefighters as distributors of workplace safety and health information to small businesses

BACKGROUND

Small businesses bear a large burden of injury and death, and are difficult to reach with occupational safety and health (OSH) information. The National Institute for Occupational Safety and Health (NIOSH) developed a pilot study testing the feasibility of fire departments disseminating OSH information to small businesses during fire inspections.

METHODS

Two sets of postcards were developed with unique, trackable URLs for the NIOSH Small Business Resource Guide. One set was distributed by firefighters, the other was mailed to small businesses. Participating inspectors were met with to discuss their experience.

RESULTS

Neither distribution method resulted in a substantial number of site visits. Inspectors believed distributing postcards was an easy addition to their duties, and saw value in safety information.

CONCLUSIONS

There are barriers beyond awareness of availability that prevent small business owners from seeking OSH information. Research should focus on identifying barriers and developing better OSH information diffusion mechanisms.

Findings From the National Machine Guarding Program-A Small Business Intervention: Machine Safety

Supplemental Digital Content is available in the text

Objectives:

The purpose of this nationwide intervention was to improve machine safety in small metal fabrication businesses (3 to 150 employees). The failure to implement machine safety programs related to guarding and lockout/tagout (LOTO) are frequent causes of Occupational Safety and Health Administration (OSHA) citations and may result in serious traumatic injury.

Methods:

Insurance safety consultants conducted a standardized evaluation of machine guarding, safety programs, and LOTO. Businesses received a baseline evaluation, two intervention visits, and a 12-month follow-up evaluation.

Results:

The intervention was completed by 160 businesses. Adding a safety committee was associated with a 10% point increase in business-level machine scores (P < 0.0001) and a 33% point increase in LOTO program scores (P < 0.0001).

Conclusions:

Insurance safety consultants proved effective at disseminating a machine safety and LOTO intervention via management-employee safety committees.

Findings From the National Machine Guarding Program: A Small Business Intervention: Lockout/Tagout

OBJECTIVE

Failure to implement lockout/tagout (LOTO) procedures adversely affects the rate of work-related fatalities and serious traumatic injury and is one of the most frequently cited Occupational Safety and Health Administration standards. This study assesses the impact of a nationwide intervention to improve LOTO in small metal fabrication businesses.

METHODS

Insurance safety consultants conducted a standardized and validated evaluation of LOTO programs and procedures. Businesses received a baseline evaluation, two intervention visits, and a 12-month follow-up evaluation.

RESULTS

The intervention was completed by 160 businesses. The mean LOTO procedure score improved from 8% to 33% (P < 0.0001), the mean program score went from 55% to 76% (P < 0.0001), and the presence of lockable disconnects went from 88% to 92% (P < 0.0001).

CONCLUSIONS

This nationwide intervention showed substantial improvements in LOTO. It provides a framework for assessing and improving LOTO.

Exploring Environment-Intervention Fit: A Study of a Work Environment Intervention Program for the Care Sector

Targeting occupational health and safety interventions to different groups of employees and sectors is important. The aim of this study was to explore the environment-intervention fit of a Danish psychosocial work environment intervention program for the residential and home care sector. Focus group interviews with employees and interviews with mangers were conducted at 12 selected workplaces and a questionnaire survey was conducted with managers at all 115 workplaces. The interventions enhanced the probability of employees experiencing more "good" work days, where they could make a difference to the lives of clients. The interventions may therefore be characterized as culturally compelling and having a good fit with the immediate work environment of employees. The interventions furthermore seemed to fit well with the wider organizational environment and with recent changes in the societal and economic context of workplaces. However, some workplaces had difficulties with involving all employees and adapting the interventions to the organization of work. The findings suggest that flexibility and a variety of strategies to involve all employees are important aspects, if interventions are to fit well with the care sector. The focus on employees' conceptualization of a "good" work day may be useful for intervention research in other sectors.

Application of a model for delivering occupational safety and health to smaller businesses: Case studies from the US

Smaller firms are the majority in every industry in the US, and they endure a greater burden of occupational injuries, illnesses, and fatalities than larger firms. Smaller firms often lack the necessary resources for effective occupational safety and health activities, and many require external assistance with safety and health programming. Based on previous work by researchers in Europe and New Zealand, NIOSH researchers developed for occupational safety and health intervention in small businesses. This model was evaluated with several intermediary organizations. Four case studies which describe efforts to reach small businesses with occupational safety and health assistance include the following: trenching safety training for construction, basic compliance and hazard recognition for general industry, expanded safety and health training for restaurants, and fall prevention and respirator training for boat repair contractors. Successful efforts included participation by the initiator among the intermediaries' planning activities, alignment of small business needs with intermediary offerings, continued monitoring of intermediary activities by the initiator, and strong leadership for occupational safety and health among intermediaries. Common challenges were a lack of resources among intermediaries, lack of opportunities for in-person meetings between intermediaries and the initiator, and balancing the exchanges in the initiator-intermediary-small business relationships. The model offers some encouragement that initiator organizations can contribute to sustainable OSH assistance for small firms, but they must depend on intermediaries who have compatible interests in smaller businesses and they must work to understand the small business social system.

Development of a program logic model and evaluation plan for a participatory ergonomics intervention in construction

BACKGROUND

Intervention studies in participatory ergonomics (PE) are often difficult to interpret due to limited descriptions of program planning and evaluation.

METHODS

In an ongoing PE program with floor layers, we developed a logic model to describe our program plan, and process and summative evaluations designed to describe the efficacy of the program.

RESULTS

The logic model was a useful tool for describing the program elements and subsequent modifications. The process evaluation measured how well the program was delivered as intended, and revealed the need for program modifications. The summative evaluation provided early measures of the efficacy of the program as delivered.

CONCLUSIONS

Inadequate information on program delivery may lead to erroneous conclusions about intervention efficacy due to Type III error. A logic model guided the delivery and evaluation of our intervention and provides useful information to aid interpretation of results.

A model for occupational safety and health intervention diffusion to small businesses

BACKGROUND

Smaller businesses differ from their larger counterparts in having higher rates of occupational injuries and illnesses and fewer resources for preventing those losses. Intervention models developed outside the United States have addressed the resource deficiency issue by incorporating intermediary organizations such as trade associations.

METHODS

This paper extends previous models by using exchange theory and by borrowing from the diffusion of innovations model. It emphasizes that occupational safety and health (OSH) organizations must understand as much about intermediary organizations as they do about small businesses. OSH organizations ("initiators") must understand how to position interventions and information to intermediaries as added value to their relationships with small businesses. Examples from experiences in two midwestern states are used to illustrate relationships and types of analyses implied by the extended model.

RESULTS

The study found that intermediary organizations were highly attuned to providing smaller businesses with what they want, including OSH services. The study also found that there are opinion leader organizations and individual champions within intermediaries who are key to decisions and actions about OSH programming.

CONCLUSIONS

The model places more responsibility on both initiators and intermediaries to develop and market interventions that will be valued in the competitive small business environment where the resources required to adopt each new business activity could always be used in other ways. The model is a candidate for empirical validation, and it offers some encouragement that the issue of sustainable OSH assistance to small businesses might be addressed. Am. J. Ind. Med. 56:1442-1451, 2013. Published 2013. This article is a U.S. Government work and is in the public domain in the USA.