Total Worker Health® Intervention for Construction Workers Alters Safety, Health, Well-Being Measures

Proposed Framework for Developing and Evaluating Total Worker Health ® Education and Training Programs

OBJECTIVE

Propose a framework for developing and evaluating Total Worker Health ® (TWH) education and training efforts by implementing institutions.

METHODS

This is a review of TWH information from symposia, workshops, academic offerings, and publications, along with a review of education and training development and evaluation resources applicable across various disciplines.

RESULTS

Examples of knowledge, skills, and abilities (KSAs) are provided for each TWH core competency, and a framework for developing and evaluating a TWH competency-based education or training program.

CONCLUSIONS

The proposed set of KSAs and framework for developing and evaluating TWH education or training programs may inform future pilot testing of KSAs and framework by implementing institutions and help standardize practices across the discipline. Academic, business, community, labor, and government stakeholders are encouraged to provide further input to assist in its maturation and uptake.

The Total Worker Health® (TWH) approach: a systematic review of its application in different occupational settings

BACKGROUND

The National Institute for Occupational Safety and Health (NIOSH), in 2011, developed the "Total Worker Health®" (TWH) as a holistic approach to protect and promote the workers' safety, health, and well-being. After over ten years from the TWH development, the aim of the present systematic review is to provide a comprehensive overview of the worldwide TWH initiatives.

METHODS

PubMed, Scopus and ISI Web of Science were searched for TWH studies published up to the 31st of July 2023, and 43 investigations could be included. The review was registered on the International prospective register of systematic reviews PROSPERO with the reference number CRD42023416972.

RESULTS

Issues that emerged as relevant for the TWH operationalization were the awareness about the TWH approach and fundamentals, the leadership commitment, and a participatory engagement of the workforce: these aspects all contributed to acceptable and effective setting oriented TWH plans, specifically tailored on the peculiarities of the workplace, including small enterprises and multiemployer worksites. Evaluation and continual improvement were reported as fundamental for the successful implementation of TWH initiatives. Limited resources for safety and health initiatives, in terms of time, people, and funds, together with difficulties in the identification of safety and health priorities and a poor participatory culture were recognized as obstacles to the TWH application. Training resulted the core component of the TWH leadership and workforce preparedness, with beneficial results in terms of safety culture and adoption of preventive measures.

CONCLUSIONS

Although interesting aspects emerged from our review, future longitudinal investigations should confirm the effectiveness, easy integration, and long-term sustainability of TWH models in different workplaces, in order to effectively support safe and health-enhancing works able to improve innovation and productivity.

A pilot study on psychosocial factors and perceptions of organizational health among a sample of U.S. waste workers

Solid waste workers encounter a number of occupational hazards that are likely to induce stress. Thus, there are likely to be psychosocial factors that also contribute to their overall perceptions of organizational health. However, attitudes regarding the aforementioned among solid waste workers' have not been assessed. This descriptive, cross-sectional pilot study operationalized the INPUTS Survey to determine workers' perceptions of organizational health and other psychosocial factors of work. Percentage and mean responses to each INPUTS domain are presented in accordance with their survey manual. Pearson's chi-squared tests were run on count data; Fisher's exact tests were run for count data with fewer than five samples. ANOVAs were run on the continuous items. Due to a relatively low sample size (N = 68), two-sided p values < 0.1 were considered statistically significant. Most solid waste worker participants reported high decision authority, that they perceived their management to prioritize workplace health and safety, and had high job satisfaction. However, perceptions of support for health outside of the realm of occupational safety and health was lower. Addressing traditional occupational health hazards continues to take precedence in this industry, with less of a focus on how the social determinants of health may impact workplace health.

Job Satisfaction in Remote Work: The Role of Positive Spillover from Work to Family and Work-Life Balance

The objective of this research is to propose and validate a theoretical model that explains job satisfaction in remote work influenced by family-supportive supervisory behaviors (FSSBs) and, in addition, to evaluate the mediating role of work-to-family positive spillover (WFPS) and work-life balance (WLB) in this influence. A non-experimental cross-sectional study was conducted using a self-administered survey to a sample of 396 teleworkers in Lima, Peru. The hypothesized model was analyzed using PLS-SEM based structural equation modeling. The results show that FSSB has a direct effect on both job satisfaction in remote work and WFPS and WLB. In addition, it shows that WFPS and WLB have positive effects on job satisfaction in remote work. Also, the results show that WFPS and WLB have a mediating role in the influence of FSSB on job satisfaction in remote work. In conclusion, this study highlights the importance of supervisor behavior, positive work-to-family spillover, and work-life balance in remote workers' job satisfaction. It is suggested that companies adopt policies and practices that encourage work-life balance as well as a favorable supervisory environment.

Revealing the practical strategies for promoting Chinese migrant workers' health and well-being: Organizational empowerment perspective

The health and well-being of migrant workers struggling to make ends meet are being compromised, especially with the uncertainty of the COVID-19 pandemic. The aim is to analyze how organizational empowerment promotes health and well-being from an applied psychological perspective, taking into account the shaping role of individual vulnerability. Links between theory and practice will be established to achieve equitable health and well-being. The underlying mechanism by which organizational empowerment mitigated workplace-induced adverse outcomes was validated in the analysis of construction workers (n = 966). In addition, individual characteristics, namely, excitability, low perceptual threshold, control, and knowledge, attitude, and practice, were identified as critical factors, as well-being consequences vary from person to person. Moderating effect analysis showed that high excitability enhanced the association between work environment exposure and health and well-being. Control and knowledge, attitude, and practice have opposite effects. Moreover, the dual effects of the low perception threshold are verified, that is, facing the work environment produces more negative consequences, whereas perceiving more resources stimulates more positive consequences. Overall, the research provides a clearer dialectical view of vulnerability, contributing wisdom toward accurate management based on empowerment theory, which lays a solid foundation for bridging gaps in health and well-being.

By Nature, We're Doers and Problem Solvers: Evolving Job Demands and Resources in Response to COVID-19 Among US-Based Fire Service Personnel (The RAPID Study II)

OBJECTIVE

The US fire service experienced increased demands due to COVID-19. This qualitative study explored the pandemic's impact on work-life balance and safety.

METHODS

Five interviews and 10 focus groups were conducted with 15 fire departments in the COVID-19 RAPID Mental Health Assessment. Coding and multilevel content analysis were conducted in NVivo.

RESULTS

Four department support themes were identified: emotional/social (33.1%), policy (28.4%), instrumental (22.9%), and informational (15.5%). Four work-life balance themes were identified: life (51.2%), children (18.1%), physiological (16.5%), and work (14.2%). We observed more departmental resources to help mitigate job demands within the work environment compared with those for work-life demands.

CONCLUSIONS

Job resources are needed to mitigate demands and improve safety culture and mental well-being of the fire service under normal conditions, and for the next pandemic, natural disaster, or long-term emergency.

The effectiveness of organisational-level workplace mental health interventions on mental health and wellbeing in construction workers: A systematic review and recommended research agenda

Objectives

This systematic review assesses the scientific evidence regarding the effectiveness of organisational-level workplace mental health interventions on stress, burnout, non-clinical depressive and anxiety symptoms, and wellbeing in construction workers.

Methods

Eligibility criteria were randomized controlled trials (RCTs), cluster randomized controlled trials (cRCTs), controlled or uncontrolled before- and after studies published in peer-reviewed journals between 2010 and May 2022 in five databases (Academic Search Complete, PsycInfo, PubMed, Scopus and Web of Science). Outcomes were stress, burnout and non-clinical depression and anxiety symptoms, and wellbeing (primary) and workplace changes and sickness absenteeism (secondary). Quality appraisal was conducted using the QATQS scale, a narrative synthesis was applied. The protocol was published in PROSPERO CRD42020183640 https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020183640.

Main results

We identified five articles (four studies) with a total sample size of 260, one cRCT, one controlled before- and after study, and two uncontrolled before- and after studies. The methodological quality of one study was rated as moderate, while for three studies it was weak. One study showed significant effects of a work redesign programme in short-term physiological stress parameters, one study showed a significant employee perceived improvement of information flow after supervisor training and one study showed a substantial non-significant decline in sick leave. There was no significant effect on general mental health (SF12) nor on emotional exhaustion. The focus of all studies was on physical health, while detailed mental health and wellbeing measures were not applied.

Main conclusions

The evidence for the effectiveness of organisational-level workplace mental health interventions in construction workers is limited with opportunities for methodological and conceptual improvement. Recommendations include the use of a wider range of mental health and wellbeing outcomes, interventions tailored to the specific workplace and culture in construction and the application of the principles of complex interventions in design and evaluation.

Adapting, adopting, and advancing change: A framework for future research in the psychology of occupational safety

INTRODUCTION

While there are numerous reviews of the research on the psychology of occupational safety, these studies provide weak guidance on where the research should go next. Accordingly, we introduce a simple framework for thinking about future research in this area: the adapting, adopting, and advancing change framework. This framework summarizes how external, technological, and theoretical developments have driven research in the psychology of occupational safety and uses these observations as evidence to imagine ways in which they may continue to do so.

METHOD

We critically reviewed seminal research in the psychology of occupational safety using the adapting, adopting, and advancing change framework. Adapting to change means considering external changes such as the fluctuating nature of work and the labor market. Adopting change refers to incorporating the latest technological and technical advances to facilitate more robust research methods and analyses. Finally, advancing change refers to theoretical advances and how they will push psychology of occupational safety research forward.

RESULTS

We highlight several avenues for future research that emerge at the convergence of the framework's three themes, including developing the safety skill construct, assessing variation in demand appraisals on safety outcomes, distinguishing safety climate from related constructs, and examining safety constructs that are usually considered as outcomes (e.g., injuries) as predictors instead.

CONCLUSIONS

In doing so, we provide a clear structure to help researchers better identify the most effective directions for future research on the psychology of occupational safety.

Factors Affecting Workplace Well-Being: Building Construction Projects

This study explores the factors affecting workplace well-being in building construction projects. The objectives of this study are (1) to investigate the critical factors for workplace well-being in building construction projects, (2) to compare the critical factors between large enterprises (LEs) and small-medium enterprises (SMEs), and (3) to compare the critical factors between high-rise building construction projects and non-high-rise building construction projects. Data from 21 semi-structured interviews with construction industry professionals in Malaysia and a systematic literature review were used to develop a potential list of factors. Then, the factors were used to create a survey that was distributed to industry professionals. Data from 205 valid responses were analyzed using mean score ranking, normalization, the Kruskal–Wallis test, and overlap analysis. Fourteen critical factors were determined, including salary package, working hours, project progress, planning of the project, workers’ welfare, relationship between top management and employees, timeline of salary payment, working environment, employee work monitoring, communication between workers, insurance for construction worker, general safety and health monitoring, collaboration between top management and employee, and project leadership. This study contributes to the body of knowledge by identifying the critical factors for improving workplace well-being. The study findings allow researchers and practitioners to develop strategies to promote workplace well-being in building construction projects.

Long Work Hours, Overtime, and Worker Health Impairment: A Cross-Sectional Study among Stone, Sand, and Gravel Mine Workers

Background: Research has shown that long work hours and overtime are associated with health impairment, including stress, burnout, and overall health. However, this has not been thoroughly assessed among stone, sand, and gravel mine workers. As such, this study examined whether significant differences in stress, burnout, and overall health existed among workers that worked different hours each week. Methods: ANOVA analyses were completed for the outcome variables (stress, burnout, and health status). Each analysis included three categorical independent variables: age, sex, and work hours. Age and sex were control variables. BMI was added to the health status analysis as an additional control variable. Results: There were significant differences between work hour groups for all three outcomes. Post hoc analyses determined that workers working >60 h/week had more stress, more burnout, and lower health. Differences were not found between age or sex. There were no differences in health status for different BMI groups, but the interaction of BMI and work hours was significant. Conclusions: Working more than 60 h per week was problematic. Mine and safety administrators should enact programs to protect and promote worker health, particularly among those working long hours, especially if more than 60 h per week.

Small + Safe + Well: lessons learned from a Total Worker Health® randomized intervention to promote organizational change in small business

BACKGROUND

Leadership commitment to worker safety and health is one of the most important factors when organizations develop and implement a Total Worker Health® approach. We aimed to assess the effectiveness of a Total Worker Health ("TWH") leadership development program that targeted owners and other senior-level leadership positions on changing organizational and worker outcomes from baseline to one-year later.

METHODS

The Small + Safe + Well study included small businesses from a variety of industries in the state of Colorado, USA that were participating in Health Links™. We designed a randomized waitlisted control comparison design (RCT) to evaluate the added benefit of a TWH leadership development program. An employer assessment tool was used to assess TWH policies and programs, and an employee health and safety survey was used to assess safety leadership and health leadership practices, safety climate and health climate, safety behaviors and health behaviors, and well-being. We used a linear mixed model framework with random effects for business and employee to assess the impact of intervention on the outcomes of interest.

RESULTS

Thirty-six businesses (37% retention) and 250 employees (9% retention) met the RCT study inclusion criteria and were included in the analysis. Businesses improved their TWH policies and programs score from baseline to one-year later, regardless of leadership intervention group assignment. Neither intervention group demonstrated improvements in employee-reported outcomes.

CONCLUSIONS

This study sought to address a gap in the literature regarding small business senior leadership development for TWH. Our study demonstrates many of the challenges of conducting studies focused on organizational change in workplaces, specifically in small businesses. When designing TWH intervention studies, researchers should consider how to best engage small business leaders in interventions and implementations early on, as well as methods that are well matched to measuring primary and secondary outcomes longitudinally. Future research is needed to test the feasibility and sustainability of TWH interventions in small business.

TRIAL REGISTRATION

The trial was retrospectively registered with ClinicalTrials.gov ( ID U19OH011227 ).

Impact of COVID-19 on health and safety in the construction sector

Construction has been significantly affected by COVID-19 yet is critical to the post-COVID economic recovery. Specifically, construction needs to be constantly aware of safety and risk balanced with timely project delivery. Guidance for COVID-19 must therefore be implemented in a way that reflects working practice and pressures. There is, however, a potential knowledge gap regarding the practical feasibility and impact of applying COVID-19 measures within construction, made more difficult by factors such as the temporary nature of projects and complex working arrangements. This article presents a commentary on safe construction during, and beyond, COVID-19, covering the human factors challenges and practicalities of implementing COVID-19 measures. We observe that while guidance is strong on risk management, understanding of how best to implement this guidance is not yet stable. Also, care must be taken that implementing guidance does not detract from general safety, which is also challenged by increased pressures on delivery arising from COVID-19. There may, however, be opportunities for safer working practice arising from new awareness of health, hygiene, and safety risk. The role of safety leadership is overlooked in guidance yet is vital to ensure safe application of COVID-19 working practices. The key message is that COVID-19 needs to be integrated and promoted within a general risk management approach, in part because this takes account of differing priorities regarding safety risks, rather than overly focussing on COVID-19, and also because the effectiveness of COVID-19 mitigations can be amplified by integration with pre-existing safety processes.

Health Risk Behavior Profile of Construction Workers, 32 States, 2013 to 2016

BACKGROUND

Research has suggested that several health risk behaviors were more prevalent among construction workers than among the general workforce.

METHODS

The prevalences of six health risk behaviors among construction workers were compared with workers in other industries using data from 32 states in the 2013 to 2016 Behavioral Risk Factor Surveillance System (BRFSS).

RESULTS

Smoking, smokeless tobacco use, binge drinking, no leisure-time physical activity, and not always using a seatbelt were significantly more prevalent (P < 0.001), and short sleep significantly less prevalent (P < 0.05), for all construction workers combined compared with workers in other industries. Prevalences varied substantially for all six health risk behaviors by construction occupation.

CONCLUSIONS

Due to the high prevalence of some health risk behaviors, construction workers may benefit from interventions to reduce these behaviors, particularly since they are also potentially exposed to workplace hazards.

The Application of the Theory Coding Scheme to Interventions in Occupational Health Psychology

OBJECTIVE

There is a need to understand how and to what extent theory is used to inform occupational health psychology (OHP) interventions. This study examines the utility of Michie and Prestwich1 theory coding scheme (TCS) to examine the theoretical base of OHP interventions.

METHODS

We applied the TCS to a systematically derived sample of 27 papers that reported evaluation data for work-related interventions seeking to improve employee sleep quantity or quality.

RESULTS

Results indicated that the original TCS was largely applicable to OHP sleep interventions. After several minor modifications to its evaluative criteria, the TCS successfully accommodates a range of OHP intervention designs.

CONCLUSIONS

The revised TCS for OHP interventions allows for a more detailed understanding of the role and use of theory in OHP interventions and may prove to be a valuable tool for OHP researchers and practitioners.

A Comparison of Safety, Health, and Well-Being Risk Factors Across Five Occupational Samples

Objective: The aim of this study was to present safety, health and well-being profiles of workers within five occupations: call center work (N = 139), corrections (N = 85), construction (N = 348), homecare (N = 149), and parks and recreation (N = 178). Methods: Baseline data from the Data Repository of Oregon's Healthy Workforce Center were used. Measures were compared with clinical healthcare guidelines and national norms. Results: The prevalence of health and safety risks for adults was as follows: overweight (83.2%), high blood pressure (16.4%), injury causing lost work (9.9%), and reported pain (47.0%). Young workers were least likely to report adequate sleep (46.6%). Construction workers reported the highest rate of smoking (20.7%). All of the adult workers reported significantly lower general health than the general population. Conclusion: The number of workers experiencing poor safety, health and well-being outcomes suggest the need for improved working conditions.

The active workplace study: Protocol for a randomized controlled trial with sedentary workers

OBJECTIVES

Sedentary behavior is pervasive in the workplace and is harmful to health. Research on the effectiveness of comprehensive workplace interventions to reduce sedentary behavior and improve worker health and safety is crucial as sedentary jobs become more common.

METHODS

We developed a Total Worker Health intervention targeting sedentary behavior in call centers, and are evaluating intervention effectiveness in a randomized controlled trial. Four worksites will be randomly assigned to an intervention or control condition. The intervention condition includes the provision of active workstations along with programs and procedures at environmental, organizational, and individual levels. Control worksites will receive active workstations with no additional support, following common organizational practices.

RESULTS

Outcomes include objectively measured physical activity, biological markers of health, and self-report survey data at baseline, after the 6-month intervention or control period, and at a 12-month follow-up.

CONCLUSIONS

The aims of the study are to determine whether a Total Worker Health intervention has stronger impacts on workplace sedentary behavior, uninterrupted bouts of sitting, and worker health and safety compared to a usual practice control condition. The study will inform future workplace sedentary behavior intervention and dissemination research, along with organizational best practices for reducing sedentary behavior in the workplace.

Assessing Workplace Health and Safety Strategies, Trends, and Barriers through a Statewide Worksite Survey

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.