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Rovniak LS, Cho J, Freivalds A, Kong L, De Araujo-Greecher M, Bopp M, Sciamanna CN, Rothrock L. Effects of Desk Pedaling Work Rate on Concurrent Work Performance among Physically Inactive Adults: A Randomized Experiment. Med Sci Sports Exerc 2023; 55:20-31. [PMID: 35977110 PMCID: PMC9771969 DOI: 10.1249/mss.0000000000003026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
PURPOSE Under-desk pedaling devices could help reduce health risks associated with the global decline in work-related energy expenditure. However, the optimal pedaling work rate to facilitate concurrent work performance among physically inactive adults is unclear. We examined the effects of two light-intensity pedaling work rates on physically inactive adults' work performance. METHODS We recruited equal numbers of older (45-65 yr) versus younger (20-44 yr), male versus female, and overweight/obese (body mass index [BMI], 25-35 kg·m -2 ) versus normal weight (BMI, 18.5-24.9 kg·m -2 ) participants. Using a Graeco-Latin square design, participants ( n = 96) completed a laboratory experiment to evaluate the effects of using an under-desk pedaling device at two seated light-intensity work rates (17 and 25 W), relative to a seated nonpedaling condition on objectively measured typing, reading, logical reasoning, and phone task performance. Ergonomic comfort under each pedaling work rate was also assessed. Equivalence tests were used to compare work performance under the pedaling versus nonpedaling conditions. RESULTS Treatment fidelity to the 17- and 25-W pedaling work rates exceeded 95%. Mean work performance scores for each pedaling and nonpedaling condition were equivalent under alpha = 0.025. Age, sex, and BMI did not significantly moderate the effect of pedaling on work performance. Participants reported greater ergonomic comfort while completing work tasks at the 17-W relative to the 25-W work rate. CONCLUSIONS Physically inactive adults obtained similar work performance scores under the 17- and 25-W pedaling and the nonpedaling conditions, suggesting that either pedaling work rate could help reduce health risks of sedentary work time. The 17-W work rate yielded greater ergonomic comfort and may be an appropriate starting point for introducing diverse inactive workers to under-desk pedaling.
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Affiliation(s)
- Liza S. Rovniak
- Division of General Internal Medicine, Departments of Medicine and Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA
| | - Jay Cho
- Department of Industrial and Manufacturing Engineering, Pennsylvania State University, University Park, PA
| | - Andris Freivalds
- Department of Industrial and Manufacturing Engineering, Pennsylvania State University, University Park, PA
| | - Lan Kong
- Division of Biostatistics and Bioinformatics, Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA
| | | | - Melissa Bopp
- Department of Kinesiology, Pennsylvania State University, University Park, PA
| | - Christopher N. Sciamanna
- Division of General Internal Medicine, Departments of Medicine and Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA
| | - Ling Rothrock
- Department of Industrial and Manufacturing Engineering, Pennsylvania State University, University Park, PA
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Mannino GC, Mancuso E, Sbrignadello S, Morettini M, Andreozzi F, Tura A. Chemical Compounds and Ambient Factors Affecting Pancreatic Alpha-Cells Mass and Function: What Evidence? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16489. [PMID: 36554367 PMCID: PMC9778390 DOI: 10.3390/ijerph192416489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/02/2022] [Accepted: 12/04/2022] [Indexed: 06/17/2023]
Abstract
The exposure to different substances present in the environment can affect the ability of the human body to maintain glucose homeostasis. Some review studies summarized the current evidence about the relationships between environment and insulin resistance or beta-cell dysfunction. Instead, no reviews focused on the relationships between the environment and the alpha cell, although in recent years clear indications have emerged for the pivotal role of the alpha cell in glucose regulation. Thus, the aim of this review was to analyze the studies about the effects of chemical, biological, and physical environmental factors on the alpha cell. Notably, we found studies focusing on the effects of different categories of compounds, including air pollutants, compounds of known toxicity present in common objects, pharmacological agents, and compounds possibly present in food, plus studies on the effects of physical factors (mainly heat exposure). However, the overall number of relevant studies was limited, especially when compared to studies related to the environment and insulin sensitivity or beta-cell function. In our opinion, this was likely due to the underestimation of the alpha-cell role in glucose homeostasis, but since such a role has recently emerged with increasing strength, we expect several new studies about the environment and alpha-cell in the near future.
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Affiliation(s)
- Gaia Chiara Mannino
- Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy
| | - Elettra Mancuso
- Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy
| | | | - Micaela Morettini
- Department of Information Engineering, Università Politecnica delle Marche, 60131 Ancona, Italy
| | - Francesco Andreozzi
- Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy
| | - Andrea Tura
- CNR Institute of Neuroscience, 35127 Padova, Italy
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Smith TD, Balogun AO, Dillman AL. Management Perspectives on Musculoskeletal Disorder Risk Factors and Protective Safety Resources within the Stone, Sand, and Gravel Mining Industry. Workplace Health Saf 2022; 70:242-250. [PMID: 35438012 DOI: 10.1177/21650799221089196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Musculoskeletal disorders (MSD) are problematic in many industries, including stone, sand, and gravel mining (SSGM). This research aimed to delineate MSD risk factors and to identify protective safety resources that reduce MSD within these operations. METHODS A deductive content analysis of recorded transcripts from a focus group, which included professionals working in SSGM organizations, was completed. FINDINGS Results suggested demographic and personal factors associated with MSD included age, lack of experience, low levels of physical fitness, and attitudes toward risks. Work factors and job demands included excessive lifting, performing additional job duties, production-focused operations, lack of resources, and work related to maintenance and equipment operation. Suggested safety resources included a focus on worker fitness, resource adequacy, pay and benefits, the SLAM (Stop, Look, Analyze, and Manage) process and positive safety culture. CONCLUSION This qualitative research project utilized mine experts to identify demographic, personal, work, and job demand factors they perceive or know to be associated with MSD. Safety programs suggested by these same experts to reduce MSD were also presented. APPLICATION TO PRACTICE Occupational health and safety practitioners and mine administrators should focus on the identified factors in their work to prevent MSD within SSGM operations. Safety efforts need to include integrated programs that promote health and fitness as well. These efforts should be implemented along with recommended programs such as SLAM and the provision of appropriate safety resources to minimize risks. These efforts should promote the importance of safety and will help with bolstering a positive safety culture.
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Sanetti LMH, Pierce AM, Gammie L, Dugan AG, Cavallari JM. Scale-out of a Total Worker Health® approach for designing interventions to reduce teacher stress: pilot implementation evaluation. BMC Public Health 2022; 22:814. [PMID: 35461229 PMCID: PMC9034693 DOI: 10.1186/s12889-022-13241-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 04/07/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Teachers have high rates of daily stress and the majority of available interventions are focused at the teacher-level. Yet, best practices in Total Worker Health® approaches indicate organization-level interventions identified using a participatory approach are most effective. We conducted an exploratory scale-out pilot study to examine the adoption of the Healthy Workplace Participatory Program (HWPP), an evidence-based, Total Worker Health approach to engage employees (e.g., teachers) and supervisory personnel (e.g., administrators) in the design and implementation of workplace well-being interventions within two elementary schools. METHODS We evaluated the program both quantitatively and qualitatively collecting implementation outcome data (i.e., fidelity, acceptability, understanding, feasibility, system alignment) as well as data-driven adaptations using the Framework for Reporting Adaptations and Modifications-Expanded. Data from the first school informed scale-out adaptation of the HWPP intervention, HWPP-Education, within the second school. We compared implementation outcomes between Pilot Schools 1 and 2 to evaluate improvements in the adapted HWPP. RESULTS Adaptations to HWPP program content and process were suggested to increase feasibility and contextual fit. Acceptability, understanding, and feasibility ratings showed statistically significant improvements comparing School 1 to School 2 which implemented the improved HWPP-Education. Furthermore, users reported adaptations including shorter meeting design and faster process were feasible within their work context. CONCLUSION This pilot study is the first attempt to scale out the HWPP to educators, and while not intended to confirm efficacy, it showed promising results for scale-out. Results from Pilot Schools 1 and 2 suggest systematic use of quantitative and qualitative implementation data can effectively inform scale-out efforts that increase critical outcomes such as fidelity, acceptability, understanding, feasibility, system alignment, and leader engagement as well as decrease the extent of system resources needed. As such, this scale-out process may be a feasible approach on which to base large-scale implementation efforts of the HWPP among educators.
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Affiliation(s)
- Lisa M H Sanetti
- Neag School of Education, Department of Educational Psychology, University of Connecticut, Storrs, CT, 06269, USA.
| | - Alexandra M Pierce
- Neag School of Education, Department of Educational Psychology, University of Connecticut, Storrs, CT, 06269, USA
| | - Lauren Gammie
- Neag School of Education, Department of Educational Psychology, University of Connecticut, Storrs, CT, 06269, USA
| | - Alicia G Dugan
- School of Medicine, Department of Medicine, Division of Occupational and Environmental Medicine, University of Connecticut Health Center, Farmington, USA
| | - Jennifer M Cavallari
- School of Medicine, Department of Medicine, Division of Occupational and Environmental Medicine, University of Connecticut Health Center, Farmington, USA
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Tenney L, Huebschmann AG, Brown CE, Schwatka NV, Newman LS. Leveraging an Implementation Science Framework to Measure the Impact of Efforts to Scale Out a Total Worker Health® Intervention to Employers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031372. [PMID: 35162408 PMCID: PMC8834848 DOI: 10.3390/ijerph19031372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 12/10/2021] [Accepted: 12/21/2021] [Indexed: 12/04/2022]
Abstract
The role of dissemination and implementation (D&I) science is critical to the translation of Total Worker Health® into practice and to the success of interventions in addressing current and future implications for worker safety, health, and well-being. D&I frameworks can guide researchers to design Total Worker Health (“TWH”) delivery approaches that use flexible implementation strategies to implement the core components of programs for employers with varying contextual factors, including small/mid/large-sized businesses and different industry types. To date, there have been very few examples of applying implementation frameworks for the translation and delivery of interventions into organizational settings that require adoption and implementation at the business level to benefit the working individuals. We present a TWH case study, Health Links™, to illustrate an approach to applying an existing implementation framework, RE-AIM, to plan, design, build, and then evaluate TWH implementation strategies. Our case study also highlights key concepts for scaling-out TWH evidence-based interventions where they are implemented in new workplace settings, new delivery systems, or both. Our example provides strong support of key implementation planning constructs including early and consistent stakeholder engagement, tailored messaging and marketing, flexibility, and adaptations in implementation strategies to maximize adoption, implementation, and maintenance among participating businesses.
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Affiliation(s)
- Liliana Tenney
- Center for Health, Work & Environment, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, 13001 E. 17th Pl., 3rd Floor, Mail Stop B119, Aurora, CO 80045, USA; (C.E.B.); (N.V.S.); (L.S.N.)
- Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, 13001 E. 17th Pl., 3rd Floor, Mail Stop B119, Aurora, CO 80045, USA
- Correspondence: ; Tel.: +1-303-724-6640
| | - Amy G. Huebschmann
- Adult & Child Consortium for Outcomes Research and Delivery Science (ACCORDS) Dissemination and Implementation Program, University of Colorado School of Medicine, Aurora, CO 80045, USA;
- Division of General Internal Medicine and Ludeman Family Center for Women’s Health Research, Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Carol E. Brown
- Center for Health, Work & Environment, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, 13001 E. 17th Pl., 3rd Floor, Mail Stop B119, Aurora, CO 80045, USA; (C.E.B.); (N.V.S.); (L.S.N.)
| | - Natalie V. Schwatka
- Center for Health, Work & Environment, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, 13001 E. 17th Pl., 3rd Floor, Mail Stop B119, Aurora, CO 80045, USA; (C.E.B.); (N.V.S.); (L.S.N.)
- Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, 13001 E. 17th Pl., 3rd Floor, Mail Stop B119, Aurora, CO 80045, USA
| | - Lee S. Newman
- Center for Health, Work & Environment, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, 13001 E. 17th Pl., 3rd Floor, Mail Stop B119, Aurora, CO 80045, USA; (C.E.B.); (N.V.S.); (L.S.N.)
- Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, 13001 E. 17th Pl., 3rd Floor, Mail Stop B119, Aurora, CO 80045, USA
- Department of Epidemiology, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, Aurora, CO 80045, USA
- Division of Pulmonary Sciences and Critical Care Medicine, School of Medicine, University of Colorado, Anschutz Medical Campus, 13001 E. 17th Pl., 3rd Floor, Mail Stop B119, Aurora, CO 80045, USA
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Siegel A, Hoge AC, Ehmann AT, Martus P, Rieger MA. Attitudes of Company Executives toward a Comprehensive Workplace Health Management-Results of an Exploratory Cross-Sectional Study in Germany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111475. [PMID: 34769990 PMCID: PMC8583484 DOI: 10.3390/ijerph182111475] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 10/26/2021] [Indexed: 11/16/2022]
Abstract
Workplace health management (WHM) in Germany aims at maintaining and increasing the health and well-being of employees. Little is known about company executives’ attitudes toward WHM. To gain more insight, we conducted a large-scale survey in companies in the German county of Reutlingen in 2017. We sent a standardized questionnaire to 906 companies, containing inter alia 26 self-constructed declarative statements depicting company executives’ opinions on various WHM aspects; 222 questionnaires could be evaluated. By exploratory factor analysis we assigned the 26 items to six factors reflecting different attitudes toward WHM. Factor values were standardized to a scale from 0 to 10. The attitude ‘positive view of general health services in the company’, for example, achieved by far the lowest mean agreement (3.3 points). For the attitude ‘general skepticism toward WHM’, agreement and disagreement were balanced (5.0 points). Using multiple regression analyses, we searched for variables that could partially explain respondents’ agreement with attitudes. In conclusion, a general WHM skepticism was widespread, but not dominant. The idea that general health services should be offered in companies was predominantly rejected. Older respondents and respondents from smaller companies and craft enterprises were more skeptical than average about WHM and its possible extensions.
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Affiliation(s)
- Achim Siegel
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, Wilhelmstr. 27, 72074 Tübingen, Germany; (A.C.H.); (A.T.E.); (M.A.R.)
- Correspondence: ; Tel.: +49-7071-29-86812
| | - Aileen C. Hoge
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, Wilhelmstr. 27, 72074 Tübingen, Germany; (A.C.H.); (A.T.E.); (M.A.R.)
| | - Anna T. Ehmann
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, Wilhelmstr. 27, 72074 Tübingen, Germany; (A.C.H.); (A.T.E.); (M.A.R.)
| | - Peter Martus
- Institute for Clinical Epidemiology and Applied Biometry, University Hospital Tübingen, Silcherstr. 5, 72076 Tübingen, Germany;
| | - Monika A. Rieger
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, Wilhelmstr. 27, 72074 Tübingen, Germany; (A.C.H.); (A.T.E.); (M.A.R.)
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Dissemination and Implementation Science Approaches for Occupational Safety and Health Research: Implications for Advancing Total Worker Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111050. [PMID: 34769573 PMCID: PMC8583149 DOI: 10.3390/ijerph182111050] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 10/09/2021] [Accepted: 10/14/2021] [Indexed: 11/16/2022]
Abstract
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.
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Peters SE, Grogan H, Henderson GM, López Gómez MA, Martínez Maldonado M, Silva Sanhueza I, Dennerlein JT. Working Conditions Influencing Drivers' Safety and Well-Being in the Transportation Industry: "On Board" Program. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910173. [PMID: 34639475 PMCID: PMC8507880 DOI: 10.3390/ijerph181910173] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/17/2021] [Accepted: 09/22/2021] [Indexed: 01/16/2023]
Abstract
The conditions of work for professional drivers can contribute to adverse health and well-being outcomes. Fatigue can result from irregular shift scheduling, stress may arise due to the intense job demands, back pain may be due to prolonged sitting and exposure to vibration, and a poor diet can be attributed to limited time for breaks and rest. This study aimed to identify working conditions and health outcomes in a bussing company by conducting focus groups and key informant interviews to inform a Total Worker Health® organizational intervention. Our thematic analysis identified three primary themes: lack of trust between drivers and supervisors, the scheduling of shifts and routes, and difficulty performing positive health behaviors. These findings demonstrate the value of using participatory methods with key stakeholders to determine the unique working conditions and pathways that may be most critical to impacting safety, health, and well-being in an organization.
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Affiliation(s)
- Susan E. Peters
- Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; (H.G.); (J.T.D.)
- Dana Farber Cancer Institute, Boston, MA 02115, USA
- Correspondence:
| | - Harrison Grogan
- Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; (H.G.); (J.T.D.)
| | - Gesele M. Henderson
- Bouvé College of Health Sciences, Northeastern University, Boston, MA 02115, USA;
- College of Osteopathic Medicine, University of New England, Biddeford, ME 04005, USA
| | | | | | | | - Jack T. Dennerlein
- Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; (H.G.); (J.T.D.)
- Bouvé College of Health Sciences, Northeastern University, Boston, MA 02115, USA;
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An Exploratory, Qualitative Study of How Organizations Implement the Hierarchy of Controls Applied to Total Worker Health®. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910032. [PMID: 34639334 PMCID: PMC8508424 DOI: 10.3390/ijerph181910032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 09/17/2021] [Accepted: 09/18/2021] [Indexed: 11/23/2022]
Abstract
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.
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Hunsucker S, Reed DB. Obesity and Work-Related Injuries Among Farmers in Kentucky, Tennessee, and West Virginia. Workplace Health Saf 2021; 69:573-579. [PMID: 34259589 DOI: 10.1177/21650799211026678] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Obesity is a recognized risk factor for work-related injuries (WRI). Despite the inherent safety hazards associated with farm work, research on obesity among farmers is limited giving little guidance to occupational health providers on obesity as a risk factor in farm WRI. This study evaluated the association between obesity and farm WRI. METHODS Cross-sectional data were collected from farmers (n = 100) in Kentucky, Tennessee, and West Virginia. Data included a survey (demographic data, farm factors, health indicators, occurrences of work-related injuries consistent with the definition of Occupational Safety and Health Administration [OSHA] recordable injuries) and direct anthropometric measures (height, weight, and waist circumference). Logistic regression was used to model any work-related injury, injuries consistent with the definition of OSHA recordables (herein called OSHA-recordable injuries), and recurrent injuries occurring during farm work performance on body mass index (BMI) and waist circumference. FINDINGS Twenty-five percent of the participants reported any injuries, and 18% reported OSHA-recordable injuries. Farmers with a BMI ≥30 kg/m2 had 3 times the risk for OSHA-recordable injuries and 5 times the risk for recurrent injuries. No significant relationship was identified between waist circumference and farm WRI. CONCLUSION This study provides evidence that increased BMI is a safety risk for farmers. Prospective studies with a larger sample are needed. Occupational health nurses and providers should educate farmers on the potential safety risk of obesity and implement weight management programs addressing obesity in farmers.
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Lemke MK. Is the Total Worker Health Program Missing Its Mark?: Integrating Complex Systems Approaches to Unify Vision and Epistemology. J Occup Environ Med 2021; 63:e304-e307. [PMID: 33928942 DOI: 10.1097/jom.0000000000002183] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Caban-Martinez AJ, Hughes J, Bator C. A Total Worker Health Approach to Skin Exposure Assessment: Experiences from the Firefighter Cancer Initiative. Ann Work Expo Health 2021; 65:143-147. [PMID: 32618337 DOI: 10.1093/annweh/wxaa066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 05/25/2020] [Accepted: 06/10/2020] [Indexed: 11/12/2022] Open
Abstract
Increasing scientific evidence suggests that addressing complex, wide-ranging concerns among worker populations should include the integration of traditional occupational safety and health with often siloed worksite wellness programs. The Total Worker Health (TWH) approach developed by the National Institute for Occupational Safety and Health can support skin cancer prevention efforts by integrating organizational-level policies, programs, and practices that strategically merge both skin protection from work-related safety and health hazards with promotion of skin illness prevention efforts. In the firefighter workforce, epidemiologic studies suggest an increased risk of skin cancer despite the use of personal protective equipment during fire incident response. Mechanisms for dermal absorption of carcinogenic compounds such as polycyclic aromatic hydrocarbons have given insight into how these hazardous chemicals can enter the skin and increase cancer risk. Mitigation of carcinogenic exposures requires a TWH approach that merges skin protection and promotion, routine surveillance, skin health assessment, worksite-based interventions, and regular evaluation of program activities. In this commentary, an example of a TWH approach is provided from the Firefighter Cancer Initiative (FCI), a transdisciplinary initiative focused at addressing excess burden of cancer in the firefighter workforce. The FCI builds on the TWH approach through the following components: (i) organizational leadership commitment; (ii) elimination of workplace hazards and promotion of worker well-being; (iii) engagement of workers in program design and delivery; (iv) ensuring confidentiality and privacy in program participation; and (v) integrating systems effectively. Occupational hygienists have strong potential to play a crucial role beyond traditional risk assessment, exposure assessment, and health protection that further includes skin health promotion and integration of related programs into a TWH framework.
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Affiliation(s)
- Alberto J Caban-Martinez
- Department of Public Health and Sciences, University of Miami, Miller School of Medicine, Miami, FL, USA.,Department of Physical Medicine and Rehabilitation, University of Miami, Miller School of Medicine, Miami, FL, USA.,Sylvester Comprehensive Cancer Center, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Jeff Hughes
- Orange County Fire Authority, Irvine, CA, USA
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Sorensen G, Dennerlein JT, Peters SE, Sabbath EL, Kelly EL, Wagner GR. The future of research on work, safety, health and wellbeing: A guiding conceptual framework. Soc Sci Med 2021; 269:113593. [PMID: 33341740 PMCID: PMC10868656 DOI: 10.1016/j.socscimed.2020.113593] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 11/19/2020] [Accepted: 12/04/2020] [Indexed: 01/08/2023]
Abstract
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.
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Affiliation(s)
- Glorian Sorensen
- Dana-Farber Cancer Institute, Boston, MA, USA; Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Jack T Dennerlein
- Harvard T.H. Chan School of Public Health, Boston, MA, USA; Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA
| | - Susan E Peters
- Dana-Farber Cancer Institute, Boston, MA, USA; Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Erika L Sabbath
- Boston College School of Social Work, Chestnut Hill, MA, USA
| | - Erin L Kelly
- MIT Sloan School of Management, Cambridge, MA, USA
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Health Links™ Assessment of Total Worker Health® Practices as Indicators of Organizational Behavior in Small Business. J Occup Environ Med 2020; 61:623-634. [PMID: 31045750 DOI: 10.1097/jom.0000000000001623] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The aim of this study was to conduct a cross-sectional assessment of the adoption of Total Worker Health (TWH) policies and practices by business size and evaluate extent and alignment of their safety and health. METHODS We conducted an analysis of 382 businesses that completed the Health Links Assessment. We measured organizational adoption of TWH across six benchmarks: organizational supports, workplace assessments, health policies and programs, safety, engagement, and evaluation. RESULTS Benchmark scores were significantly associated with business size. Larger businesses were more likely to score higher across each benchmark. CONCLUSION Small businesses are implementing TWH in a variety of ways and the level of implementation differs by business size. Practical interventions as well as dissemination and implementation research should take business size into account to ensure that TWH is both effective and sustainable in meeting the needs of employees.
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Degree of Integration Between Occupational Safety and Health Programs and Wellness Programs: First-year Results From an Insurer-Sponsored Wellness Grant for Smaller Employers. J Occup Environ Med 2020; 61:704-717. [PMID: 31205207 DOI: 10.1097/jom.0000000000001644] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of this study was to describe levels of integration between occupational safety and health (OSH) and workplace wellness programs/practices/policies ("programs") among participants in an insurer-sponsored wellness grant program. METHODS We analyzed survey responses about year 1 of an insurer-sponsored grant to start a wellness program from 220 small- and medium-sized employers. Responses yielded 25 indicators of OSH-wellness integration, and 10 additional indicators to summarize multiple responses. RESULTS At least half of the employers (N = 220) reported some level of integration within five of seven categories of OSH-wellness integration. Employers sometimes considered ergonomics, safety, or substance exposure hazards while designing their wellness program (15%) or reduced such hazards to support their wellness program (24%). Few meaningful differences were observed by employer size. CONCLUSIONS Although high levels of integration were unusual, some degree of integration was common for most indicator categories.
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Adu-Gyamfi AB. Counting the costs: occupational injuries and illnesses among auto-artisans. Int J Inj Contr Saf Promot 2020; 28:29-38. [PMID: 33064047 DOI: 10.1080/17457300.2020.1835989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Although assessing the cost of workplace injuries and illnesses as part of occupational health and safety management is important in ensuring workplace safety, the issue is generally neglected among informal auto-artisans in Ghana. This paper examines the costs of occupational injuries and illnesses in terms of productivity, financial and social aspects of selected auto-artisans who service or fabricate auto parts in Suame 'Magazine' in Kumasi, Ghana. Employing a descriptive cross-sectional design, data were collected from 957 auto-artisans selected through a multistage cluster sampling method. The study found that the most frequent occupational illnesses and injuries experienced by the auto-artisans are those related to sharp objects (83.9%), inhalation of dust particles (45.8%), objects falling from height (35.6%) and burns (21.8%). These injuries and illnesses have led to loss of productivity and income which affects family members with no variations between the various categories of auto-artisans (p = 0.976). It is concluded that occupational injuries and illnesses among informal auto-artisans presents enormous financial and emotional costs to survivors and their families. It is recommended that government should lead a policy dialogue on safety in the country's informal sector, while supporting artisans to establish insurance schemes to support them in times of injuries and illnesses.
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Punnett L, Cavallari JM, Henning RA, Nobrega S, Dugan AG, Cherniack MG. Defining 'Integration' for Total Worker Health®: A New Proposal. Ann Work Expo Health 2020; 64:223-235. [PMID: 32003780 PMCID: PMC7064271 DOI: 10.1093/annweh/wxaa003] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 01/01/2020] [Accepted: 01/07/2020] [Indexed: 12/22/2022] Open
Abstract
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.
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Affiliation(s)
- Laura Punnett
- Center for Promotion of Health in the New England Workplace, University of Massachusetts Lowell, Lowell, MA, USA
| | - Jennifer M Cavallari
- Department of Public Health Sciences, UConn School of Medicine, Farmington, CT, USA
| | - Robert A Henning
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | - Suzanne Nobrega
- Center for Promotion of Health in the New England Workplace, University of Massachusetts Lowell, Lowell, MA, USA
| | - Alicia G Dugan
- Division of Occupational and Environmental Medicine, UConn Health, Farmington, CT, USA
| | - Martin G Cherniack
- Division of Occupational and Environmental Medicine, UConn Health, Farmington, CT, USA
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Rovniak LS, Adams MA, Sciamanna CN, Kong L, Sullivan N, Costalas S, Bopp M, Kuzmik A. Effects of Bluetooth-Enabled Desk Ellipticals on Office Work Performance: Rationale, Design, and Protocol for a Randomized Trial With Overweight and Obese Adults. JMIR Res Protoc 2020; 9:e16275. [PMID: 31934871 PMCID: PMC6996735 DOI: 10.2196/16275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Revised: 10/22/2019] [Accepted: 10/26/2019] [Indexed: 11/28/2022] Open
Abstract
Background Workplaces that provide opportunities for physical activity without requiring extra time for activity could help counteract the obesity epidemic. Desk ellipticals can contribute to activity-supportive workplace environments; however, the feasibility of engaging employees in pedaling ellipticals during simultaneous office work has not been well evaluated. Objective We aim to present the rationale and methods from an ongoing randomized trial with overweight and obese employees that will evaluate (1) the effects of pedaling a compact desk elliptical on work performance and (2) the influence of different incentive types and schedules on desk pedaling quantity. Methods Overweight and obese medical center employees are being recruited in dyads for a 2 (gift card type: healthier food vs Amazon) by 3 (gift card schedule: immediate incentive contingent on individual pedaling quantity; immediate incentive partially contingent on dyads’ joint pedaling quantity; and delayed noncontingent pedaling incentive) cluster randomized within-subjects factorial trial. All participants receive a Bluetooth-enabled desk elliptical for 4 weeks and access to a mobile app that provides real-time pedaling feedback. The primary aims are to assess (1) change in employee work performance from pre- to postelliptical installation via employee and supervisor ratings and (2) effects of gift card type and schedule on quantity of objectively measured desk pedaling completed. Results Data collection is ongoing. We expect to complete main outcome analyses in 2020. Conclusions This trial represents one of the earliest attempts to assess the effects of desk pedaling and pedaling-incentive types in real-world offices. It could help bridge the research-to-practice gap by providing evidence on whether desk pedaling can be sustained without compromising work performance. International Registered Report Identifier (IRRID) DERR1-10.2196/16275
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Affiliation(s)
- Liza S Rovniak
- Division of General Internal Medicine, Departments of Medicine and Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, United States
| | - Marc A Adams
- College of Health Solutions, Arizona State University, Phoenix, AZ, United States
| | - Christopher N Sciamanna
- Division of General Internal Medicine, Departments of Medicine and Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, United States
| | - Lan Kong
- Division of Biostatistics and Bioinformatics, Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, United States
| | - Nicole Sullivan
- Division of General Internal Medicine, Departments of Medicine and Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, United States
| | - Sara Costalas
- Division of General Internal Medicine, Departments of Medicine and Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, United States
| | - Melissa Bopp
- Department of Kinesiology, Pennsylvania State University, State College, PA, United States
| | - Ashley Kuzmik
- Division of General Internal Medicine, Departments of Medicine and Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, PA, United States
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20
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Watkins C, Macy G, Golla V, Lartey G, Basham J. The "Total Worker Health" Concept: A Case Study in a Rural Workplace. J Occup Environ Med 2019; 60:387-391. [PMID: 29287032 DOI: 10.1097/jom.0000000000001273] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This case study was conducted to identify barriers of integration of health protection and health promotion in rural workplaces with tailored interventions that address the identified barriers. METHODS Data on a workplace's ability to integrate wellness programs and health protection programs were collected through a questionnaire along with a seven-question interview. Descriptive statistics were used to analyze the quantitative data. Qualitative measures were assessed using thematic analysis. Based off the results of the assessments, the company received tailored training sessions. RESULTS The largest hindrance to organizational support was time. However, improved knowledge about the need and importance of integration helped the participants to conceptualize and plan for more collaboration between departments. CONCLUSIONS New ways to increase integration at workplaces, especially rural workplaces are needed. More comprehensive interventions that include management are also needed.
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Affiliation(s)
- Cecilia Watkins
- Department of Public Health, Bowling Green (Dr Watkins, Dr Macy, Dr Lartey, Ms Basham); College of Health and Human Services (Dr Golla), Western Kentucky University, Kentucky
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21
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Rohlman DS, Campo S, Hall J, Robinson EL, Kelly KM. What Could Total Worker Health® Look Like in Small Enterprises? Ann Work Expo Health 2019; 62:S34-S41. [PMID: 30212887 DOI: 10.1093/annweh/wxy008] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Accepted: 04/30/2018] [Indexed: 11/13/2022] Open
Abstract
Small enterprises have fewer resources, are more financially precarious, and have higher rates of occupational injury and illness compared with larger enterprises. Interventions that address the promotion of health and well-being in addition to traditional occupational safety and health hazards, a Total Worker Health® (TWH) approach, may be effective in reducing injuries and preventing illness. However, little research has examined the impact of TWH interventions in small enterprises. The aim of this research was to explore and characterize health and safety practices, policies, and programs in small Midwestern enterprises from a TWH perspective. Utilizing a case studies approach, site visits were conducted with small business, between 10 and 250 employees, from 2014 through 2016 and included workplace audits and interviews with multiple employees in varying roles within each organization. Both open and closed coding were used to identify specific themes. Eight themes emerged from the site visits: value and return on investment, organizational factors, program design, engaging employees, low-cost strategies, evaluation, and integration. These themes overlapped with both the National Institute for Occupational Safety and Health's (NIOSH) Essential Elements of TWH and the NIOSH Fundamentals. Industry sector and enterprise size also affect resources and integration of these resources. As TWH expands to organizations of all sizes, it is necessary to address the unique needs of smaller enterprises.
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Affiliation(s)
- Diane S Rohlman
- Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, USA
| | - Shelly Campo
- Community and Behavioral Health, College of Public Health, University of Iowa, Iowa City, USA
| | - Jennifer Hall
- Health Promotion and Public Health, Lynchburg College, USA
| | - Erin L Robinson
- School of Social Work, University of Missouri, Columbia, USA
| | - Kevin M Kelly
- Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, USA
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22
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Predictors of Success of Workplace Physical Activity Interventions: A Systematic Review. J Phys Act Health 2019; 16:647-656. [PMID: 31203701 DOI: 10.1123/jpah.2018-0077] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 02/19/2019] [Accepted: 04/04/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Despite holding great potential for addressing concerns regarding public health, recent systematic reviews have found effect sizes for interventions targeting physical activity to be small. Before interventions can be improved, the factors influencing outcomes must be identified. This systematic review aimed to identify predictors of success, measured in terms of engagement (eg, involvement duration) and health behavior change (eg, increased step counts), of workplace interventions targeting physical activity. METHODS A structured search of 3 databases (PubMed, PsycINFO, and Web of Science) was conducted to identify articles published between January 2000 and April 2017. For inclusion, articles needed to test a workplace intervention targeting physical activity and perform a quantitative analysis, identifying predictors of engagement or health behavior change. RESULTS Twenty-two studies were identified for review (median quality score = 70%). Demographic variables (eg, gender, age) were inconsistent predictors of success. However, employees in better health and physically active at baseline were found to have a greater likelihood of success. CONCLUSIONS It appears that achieving successful results among employees at high risk of poor health outcomes remains a significant challenge for interventions. It is hoped that program developers can use this information to create effective interventions particularly for more sedentary employees.
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Sedani A, Stover D, Coyle B, Wani RJ. Assessing Workplace Health and Safety Strategies, Trends, and Barriers through a Statewide Worksite Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16142475. [PMID: 31336749 PMCID: PMC6678341 DOI: 10.3390/ijerph16142475] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 06/26/2019] [Accepted: 07/09/2019] [Indexed: 11/16/2022]
Abstract
Chronic diseases have added to the economic burden of the U.S. healthcare system. Most Americans spend most of their waking time at work, thereby, presenting employers with an opportunity to protect and promote health. The purpose of this study was to assess the implementation of workplace health governance and safety strategies among worksites in the State of Nebraska, over time and by industry sector using a randomized survey. Weighted percentages were compared by year, industry sector, and worksite size. Over the three study periods, 4784 responses were collected from worksite representatives. Adoption of workplace health governance and planning strategies increased over time and significantly varied across industry sector groups. Organizational safety policies varied by industry sector and were more commonly reported than workplace health governance and planning strategies. Time constraints were the most common barrier among worksites of all sizes, and stress was reported as the leading employee health issue that negatively impacts business. Results suggest that opportunities exist to integrate workplace health and safety initiatives, especially in blue-collar industry sectors and small businesses.
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Affiliation(s)
- Ami Sedani
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Derry Stover
- Division of Public Health, Nebraska Department of Health and Human Services, Lincoln, NE 68509, USA.
| | - Brian Coyle
- Division of Public Health, Nebraska Department of Health and Human Services, Lincoln, NE 68509, USA
| | - Rajvi J Wani
- Division of Public Health, Nebraska Department of Health and Human Services, Lincoln, NE 68509, USA
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Oneal G, Graves JM, Diede T, Postma J, Barbosa-Leiker C, Butterfield P. Balance, Health, and Workplace Safety: Experiences of New Nurses in the Context of Total Worker Health. Workplace Health Saf 2019; 67:520-528. [DOI: 10.1177/2165079919833701] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Transitioning into independent professional practice may be a difficult and trying process for newly licensed nurses, who may be at risk for burnout and quitting their jobs. Issues related to new nurses’ well-being at work may also impact their personal lives. Using thematic analysis within the framework of Total Worker Health, this study examined factors related to the overall work, safety, and health of newly licensed nurses that should be addressed in work environments to promote well-being and prevent burnout and attrition. The main component of Total Worker Health is to find and understand the relevant issues that lead to safety and health risks in the workplace and affect workers’ well-being at work and home. The overarching concept of Balance between Work and Life included three main themes: Health, Work Environment, and Learning to Be (a nurse). These themes with their subthemes described the difficulties participants had in balancing the complex interactions of work conditions and social life changes during the transition from student to professional nurse. Participants identified new physical health problems, mental health challenges, physical violence, lack of support structures at work, and alterations in family and friend relationships. However, they also developed protective factors from new connections with coworkers. These findings showed that new nurses are vulnerable to many factors at home and work that affect well-being and may lead to burnout and attrition. Implications include interventions at work that focus on health promotion, group support, and safety risk prevention through occupational nurse management.
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Affiliation(s)
- Gail Oneal
- Washington State University College of Nursing
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25
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Hoge A, Ehmann AT, Rieger MA, Siegel A. Caring for Workers' Health: Do German Employers Follow a Comprehensive Approach Similar to the Total Worker Health Concept? Results of a Survey in an Economically Powerful Region in Germany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16050726. [PMID: 30823428 PMCID: PMC6427417 DOI: 10.3390/ijerph16050726] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 02/22/2019] [Accepted: 02/26/2019] [Indexed: 11/16/2022]
Abstract
Similar to ‘Total Worker Health’ in the United States (USA), ‘Workplace Health Management’ in Germany is a holistic strategy to protect, promote, and manage employees’ health at the workplace. It consists of four subcategories. While the subcategories ‘occupational health and safety’ and ‘reintegration management’ contain measures prescribed by law, ‘workplace health promotion’ and ‘personnel development’ can be designed more individually by the companies. The present study focused on the current implementation of voluntary and legally required measures of the four subcategories, as well as companies’ satisfaction with the implementation. A total of N = 222/906 companies (small, medium, and big enterprises of one German county) answered a standardized questionnaire addressing the implementation of health-related measures, satisfaction with the implementation, and several company characteristics. In the subcategory ‘occupational health and safety’, 23.9% of the companies fulfilled all of the legally required measures, whereas in the category ‘reintegration management’, that rate amounted to 50.9%. There was a positive correlation between company size and the implementation grade, and as well between company size and the fulfilling of measures required by law. Companies tended to be more satisfied with higher implementation grades. Nevertheless, a surprisingly high proportion of the companies with poor implementation indicated satisfaction with the measures’ implementation.
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Affiliation(s)
- Aileen Hoge
- Institute of Occupational Medicine, Social Medicine and Health Services Research, University Hospital Tübingen, Wilhelmstraße 27, 72074 Tübingen, Germany.
| | - Anna T Ehmann
- Institute of Occupational Medicine, Social Medicine and Health Services Research, University Hospital Tübingen, Wilhelmstraße 27, 72074 Tübingen, Germany.
| | - Monika A Rieger
- Institute of Occupational Medicine, Social Medicine and Health Services Research, University Hospital Tübingen, Wilhelmstraße 27, 72074 Tübingen, Germany.
| | - Achim Siegel
- Institute of Occupational Medicine, Social Medicine and Health Services Research, University Hospital Tübingen, Wilhelmstraße 27, 72074 Tübingen, Germany.
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Total Worker Health® 2014⁻2018: The Novel Approach to Worker Safety, Health, and Well-Being Evolves. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16030321. [PMID: 30682773 PMCID: PMC6388217 DOI: 10.3390/ijerph16030321] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 01/16/2019] [Accepted: 01/22/2019] [Indexed: 02/06/2023]
Abstract
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.
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Biswas A, Severin CN, Smith PM, Steenstra IA, Robson LS, Amick BC. Larger Workplaces, People-Oriented Culture, and Specific Industry Sectors Are Associated with Co-Occurring Health Protection and Wellness Activities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15122739. [PMID: 30518161 PMCID: PMC6313504 DOI: 10.3390/ijerph15122739] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 11/22/2018] [Accepted: 11/28/2018] [Indexed: 11/16/2022]
Abstract
Employers are increasingly interested in offering workplace wellness programs in addition to occupational health and safety (OHS) activities to promote worker health, wellbeing, and productivity. Yet, there is a dearth of research on workplace factors that enable the implementation of OHS and wellness to inform the future integration of these activities in Canadian workplaces. This study explored workplace demographic factors associated with the co-implementation of OHS and wellness activities in a heterogenous sample of Canadian workplaces. Using a cross-sectional survey of 1285 workplaces from 2011 to 2014, latent profiles of co-occurrent OHS and wellness activities were identified, and multinomial logistic regression was used to assess associations between workplace demographic factors and the profiles. Most workplaces (84%) demonstrated little co-occurrence of OHS and wellness activities. Highest co-occurrence was associated with large workplaces (odds ratio (OR) = 3.22, 95% confidence interval (CI) = 1.15⁻5.89), in the electrical and utilities sector (OR = 5.57, 95% CI = 2.24⁻8.35), and a high people-oriented culture (OR = 4.70, 95% CI = 1.59⁻5.26). Promoting integrated OHS and wellness approaches in medium to large workplaces, in select industries, and emphasizing a people-oriented culture were found to be important factors for implementing OHS and wellness in Canadian organizations. Informed by these findings, future studies should understand the mechanisms to facilitate the integration of OHS and wellness in workplaces.
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Affiliation(s)
- Aviroop Biswas
- Institute for Work & Health, Toronto, ON M5G 2E9, Canada.
| | | | - Peter M Smith
- Institute for Work & Health, Toronto, ON M5G 2E9, Canada.
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada.
- Centre of Occupational and Environmental Health, Monash University, Melbourne, VIC 3004, Australia.
| | - Ivan A Steenstra
- Institute for Work & Health, Toronto, ON M5G 2E9, Canada.
- Morneau Shepell, Toronto, ON M5S 3A9, Canada.
| | - Lynda S Robson
- Institute for Work & Health, Toronto, ON M5G 2E9, Canada.
| | - Benjamin C Amick
- Institute for Work & Health, Toronto, ON M5G 2E9, Canada.
- Florida International University, Miami, FL 33199, USA.
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Tamers SL, Goetzel R, Kelly KM, Luckhaupt S, Nigam J, Pronk NP, Rohlman DS, Baron S, Brosseau LM, Bushnell T, Campo S, Chang CC, Childress A, Chosewood LC, Cunningham T, Goldenhar LM, Huang TTK, Hudson H, Linnan L, Newman LS, Olson R, Ozminkowski RJ, Punnett L, Schill A, Scholl J, Sorensen G. Research Methodologies for Total Worker Health®: Proceedings From a Workshop. J Occup Environ Med 2018; 60:968-978. [PMID: 30407366 PMCID: PMC6221402 DOI: 10.1097/jom.0000000000001404] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
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.
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Affiliation(s)
- Sara L Tamers
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Washington, DC (Dr Tamers, Ms Chang, Dr Childress, Dr Schill); Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Atlanta, GA (Dr Chosewood); Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Cincinnati, OH (Dr Luckhaupt, Ms Hudson, Dr Cunningham, Dr Bushnell, Dr Scholl, Ms Nigam); Johns Hopkins University, Baltimore, Maryland (Dr Goetzel); IBM Watson Health, Bethesda, Maryland (Dr Goetzel, Dr Ozminkowski); University of Iowa, Iowa City, Iowa (Dr Kelly, Dr Rohlman, Dr Campo); HealthPartners Institute, Minneapolis, Minnesota (Dr Pronk); City University of New York, New York City, New York (Dr Baron, Dr Huang); University of Illinois at Chicago, Chicago, Illinois (Dr Brosseau); Center for Construction Research and Training, Silver Spring, Maryland (Dr Goldenhar); University of North Carolina-Chapel Hill, Chapel Hill, North Carolina (Dr Linnan); Center for Health, Work & Environment, Colorado School of Public Health, University of Colorado, Colorado (Dr Newman); Oregon Health and Science University, Portland, Oregon (Dr Olson); University of Massachusetts Lowell, Lowell, Massachusetts (Dr Punnett); Harvard University, Cambridge, Massachusetts (Dr Pronk, Dr Sorensen)
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Peters SE, Grant MP, Rodgers J, Manjourides J, Okechukwu CA, Dennerlein JT. A Cluster Randomized Controlled Trial of a Total Worker Health ® Intervention on Commercial Construction Sites. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15112354. [PMID: 30366387 PMCID: PMC6265748 DOI: 10.3390/ijerph15112354] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 10/20/2018] [Accepted: 10/23/2018] [Indexed: 01/17/2023]
Abstract
This study evaluated the efficacy of an integrated Total Worker Health® program, “All the Right Moves”, designed to target the conditions of work and workers’ health behaviors through an ergonomics program combined with a worksite-based health promotion Health Week intervention. A matched-pair cluster randomized controlled trial was conducted on ten worksites (five intervention (n = 324); five control sites (n = 283)). Worker surveys were collected at all sites pre- and post- exposure at one- and six-months. Linear and logistic regression models evaluated the effect of the intervention on pain and injury, dietary and physical activity behaviors, smoking, ergonomic practices, and work limitations. Worker focus groups and manager interviews supplemented the evaluation. After controlling for matched intervention and control pairs as well as covariates, at one-month following the ergonomics program we observed a significant improvement in ergonomic practices (B = 0.20, p = 0.002), and a reduction in incidences of pain and injury (OR = 0.58, p = 0.012) in the intervention group. At six months, we observed differences in favor of the intervention group for a reduction in physically demanding work (B = −0.25, p = 0.008), increased recreational physical activity (B = 35.2, p = 0.026) and higher consumption of fruits and vegetables (B = 0.87, p = 0.008). Process evaluation revealed barriers to intervention implementation fidelity and uptake, including a fissured multiemployer worksite, the itinerant nature of workers, competing production pressures, management support, and inclement weather. The All the Right Moves program had a positive impact at the individual level on the worksites with the program. For the longer term, the multi-organizational structure in the construction work environment needs to be considered to facilitate more upstream, long-term changes.
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Affiliation(s)
- Susan E Peters
- Harvard Center for Work, Health and Wellbeing, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
| | - Michael P Grant
- Harvard Center for Work, Health and Wellbeing, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
| | - Justin Rodgers
- Department of Health Sciences, Bouvé College of Health Sciences, Northeastern University, Boston, MA 02115, USA.
| | - Justin Manjourides
- Department of Health Sciences, Bouvé College of Health Sciences, Northeastern University, Boston, MA 02115, USA.
| | - Cassandra A Okechukwu
- Harvard Center for Work, Health and Wellbeing, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
| | - Jack T Dennerlein
- Harvard Center for Work, Health and Wellbeing, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
- Department of Physical Therapy, Movement and Rehabilitation Science, Bouvé College of Health Sciences, Northeastern University, Boston, MA 02115, USA.
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Brown CE, Cunningham TR, Newman LS, Schulte PA. Conference Summary Understanding Small Enterprises Conference, 25-27 October 2017. Ann Work Expo Health 2018; 62:S1-S11. [PMID: 30212882 PMCID: PMC6350517 DOI: 10.1093/annweh/wxy061] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 06/08/2018] [Indexed: 11/13/2022] Open
Abstract
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.
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Affiliation(s)
- Carol E Brown
- Center for Health, Work & Environment, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, CO, USA
| | - Thomas R Cunningham
- Centers for Disease Control and Prevention - National Institute for Occupational Safety and Health, Cincinnati, OH, USA
| | - Lee S Newman
- Center for Health, Work & Environment and Department of Environmental & Occupational Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, CO, USA
| | - Paul A Schulte
- Centers for Disease Control and Prevention - National Institute for Occupational Safety and Health, Cincinnati, OH, USA
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Jinnett K, Schwatka N, Tenney L, Brockbank CVS, Newman LS. Chronic Conditions, Workplace Safety, And Job Demands Contribute To Absenteeism And Job Performance. Health Aff (Millwood) 2018; 36:237-244. [PMID: 28167711 DOI: 10.1377/hlthaff.2016.1151] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
An aging workforce, increased prevalence of chronic health conditions, and the potential for longer working lives have both societal and economic implications. We analyzed the combined impact of workplace safety, employee health, and job demands (work task difficulty) on worker absence and job performance. The study sample consisted of 16,926 employees who participated in a worksite wellness program offered by a workers' compensation insurer to their employers-314 large, midsize, and small businesses in Colorado across multiple industries. We found that both workplace safety and employees' chronic health conditions contributed to absenteeism and job performance, but their impact was influenced by the physical and cognitive difficulty of the job. If employers want to reduce health-related productivity losses, they should take an integrated approach to mitigate job-related injuries, promote employee health, and improve the fit between a worker's duties and abilities.
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Affiliation(s)
- Kimberly Jinnett
- Kimberly Jinnett is executive vice president of the Integrated Benefits Institute, in San Francisco, California, and an affiliate faculty member at the Institute for Health and Aging at the University of California, San Francisco
| | - Natalie Schwatka
- Natalie Schwatka is an instructor at the Colorado School of Public Health and a researcher at the Center for Health, Work, and Environment, both at the University of Colorado, in Denver
| | - Liliana Tenney
- Liliana Tenney is an instructor at the Colorado School of Public Health and deputy director of the Center for Health, Work, and Environment, both at the University of Colorado
| | | | - Lee S Newman
- Lee S. Newman is a professor at the Colorado School of Public Health and the School of Medicine and director of the Center for Health, Work, and Environment, all at the University of Colorado
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Schwatka NV, Tenney L, Dally MJ, Scott J, Brown CE, Weitzenkamp D, Shore E, Newman LS. Small business Total Worker Health: A conceptual and methodological approach to facilitating organizational change. ACTA ACUST UNITED AC 2018; 2:25-41. [PMID: 30740514 DOI: 10.1007/s41542-018-0013-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
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.
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Affiliation(s)
- Natalie V Schwatka
- 13001 E. 17 Pl., 3 Floor, Mail Stop B119 HSC, Aurora, CO 80045.,Corresponding author. , 303-724-4607
| | - Liliana Tenney
- 13001 E. 17 Pl., 3 Floor, Mail Stop B119 HSC, Aurora, CO 80045
| | - Miranda J Dally
- 13001 E. 17 Pl., 3 Floor, Mail Stop B119 HSC, Aurora, CO 80045
| | - Joshua Scott
- 13001 E. 17 Pl., 3 Floor, Mail Stop B119 HSC, Aurora, CO 80045
| | - Carol E Brown
- 13001 E. 17 Pl., 3 Floor, Mail Stop B119 HSC, Aurora, CO 80045
| | | | - Erin Shore
- 13001 E. 17 Pl., 3 Floor, Mail Stop B119 HSC, Aurora, CO 80045
| | - Lee S Newman
- 13001 E. 17 Pl., 3 Floor, Mail Stop B119 HSC, Aurora, CO 80045
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33
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Dennerlein JT. Chronic low back pain: a successful intervention for desk-bound workers. Occup Environ Med 2018; 75:319-320. [PMID: 29507051 DOI: 10.1136/oemed-2017-104981] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 02/18/2018] [Indexed: 11/04/2022]
Affiliation(s)
- Jack T Dennerlein
- Department of Physical Therapy, Movement and Rehabilitation Sciences, Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts, USA.,Center for Work, Health and Wellbeing, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
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MacDonald LA, Bertke S, Hein MJ, Judd S, Baron S, Merritt R, Howard VJ. Prevalence of Cardiovascular Health by Occupation: A Cross-Sectional Analysis Among U.S. Workers Aged ≥45 Years. Am J Prev Med 2017; 53:152-161. [PMID: 28410861 PMCID: PMC5522644 DOI: 10.1016/j.amepre.2017.02.022] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 01/25/2017] [Accepted: 02/24/2017] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Identification of groups with poor cardiovascular health (CVH) can inform where and how to target public health efforts. National prevalence estimates of CVH were derived for clinical (blood glucose, total cholesterol, blood pressure) and behavioral (BMI, diet quality, physical activity, smoking) factors among U.S. workers aged ≥45 years. METHODS This cross-sectional analysis included 6,282 employed black and white men and women aged ≥45 years enrolled in the national population-based REasons for Geographic And Racial Differences in Stroke study from 2003 to 2007. Each CVH factor was scored as ideal (2); intermediate (1); or poor (0) according to American Heart Association criteria, and summed to define optimal composite scores: CVH (sum, 10-14); clinical (sum, 5-6); and behavioral (sum, 6-8) health. Occupational data were collected 2011-2013. Analyses were conducted in 2016. RESULTS Only 14% met ideal criteria for all three clinical health factors, and none met ideal criteria for all four behavioral health factors. Sales and low status office workers had a low prevalence of optimal CVH. Service workers in protective services and the food preparation and serving occupations had a low prevalence of optimal clinical health; computer and healthcare support workers had a low prevalence of optimal behavioral health. CONCLUSIONS The prevalence of optimal CVH among middle-aged and older workers in the U.S. is low, but considerable differences exist by occupation. Targeted public health interventions may improve the CVH of at-risk older workers with different clinical and behavioral risk factor profiles employed in diverse occupational settings.
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Affiliation(s)
- Leslie A MacDonald
- Division of Surveillance, Hazard Evaluations and Field Studies, National Institute for Occupational Safety and Health, Cincinnati, Ohio.
| | - Stephen Bertke
- Division of Surveillance, Hazard Evaluations and Field Studies, National Institute for Occupational Safety and Health, Cincinnati, Ohio
| | - Misty J Hein
- Division of Surveillance, Hazard Evaluations and Field Studies, National Institute for Occupational Safety and Health, Cincinnati, Ohio
| | - Suzanne Judd
- School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Sherry Baron
- Barry Commoner Center for Health and the Environment, Queens College, Flushing, New York
| | - Robert Merritt
- Division of Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Virginia J Howard
- School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
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Sorensen G, McLellan DL, Sabbath EL, Dennerlein JT, Nagler EM, Hurtado DA, Pronk NP, Wagner GR. Integrating worksite health protection and health promotion: A conceptual model for intervention and research. Prev Med 2016; 91:188-196. [PMID: 27527576 PMCID: PMC5050152 DOI: 10.1016/j.ypmed.2016.08.005] [Citation(s) in RCA: 92] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 06/28/2016] [Accepted: 08/01/2016] [Indexed: 01/03/2023]
Abstract
There is increasing recognition of the value added by integrating traditionally separate efforts to protect and promote worker safety and health. This paper presents an innovative conceptual model to guide research on determinants of worker safety and health and to inform the design, implementation and evaluation of integrated approaches to promoting and protecting worker health. This model is rooted in multiple theories and the premise that the conditions of work are important determinants of individual safety and health outcomes and behaviors, and outcomes important to enterprises such as absence and turnover. Integrated policies, programs and practices simultaneously address multiple conditions of work, including the physical work environment and the organization of work (e.g., psychosocial factors, job tasks and demands). Findings from two recent studies conducted in Boston and Minnesota (2009-2015) illustrate the application of this model to guide social epidemiological research. This paper focuses particular attention on the relationships of the conditions of work to worker health-related behaviors, musculoskeletal symptoms, and occupational injury; and to the design of integrated interventions in response to specific settings and conditions of work of small and medium size manufacturing businesses, based on a systematic assessment of priorities, needs, and resources within an organization. This model provides an organizing framework for both research and practice by specifying the causal pathways through which work may influence health outcomes, and for designing and testing interventions to improve worker safety and health that are meaningful for workers and employers, and responsive to that setting's conditions of work.
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Affiliation(s)
- Glorian Sorensen
- Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA 02215, USA; Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA.
| | - Deborah L McLellan
- Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA 02215, USA; Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA
| | - Erika L Sabbath
- Boston College, School of Social Work, 140 Commonwealth Avenue, Chestnut Hill, MA 02467, USA
| | - Jack T Dennerlein
- Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA; Northeastern University, Bouvé College of Health Sciences, 360 Huntington Ave, Boston, MA, USA
| | - Eve M Nagler
- Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA 02215, USA; Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA
| | - David A Hurtado
- Oregon Institute of Occupational Health Science, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, L606, Portland, OR 97239, USA
| | - Nicolaas P Pronk
- Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA; HealthPartners, Inc., 8170 33rd Ave S, Bloomington, MN 55425, USA
| | - Gregory R Wagner
- Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA; National Institute for Occupational Safety and Health, 395 E Street, SW, Washington, DC 20201, USA
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