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

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.

Health Care Organization Policies for Employee Safety and COVID-19 Pandemic Response: A Mixed-Methods Study

OBJECTIVE

The coronavirus (COVID-19) pandemic impacted the well-being of health care workers. We examined the association between prepandemic perceptions of perceived organizational support for safety (using NOSACQ-50), safety hazards and the pandemic's impact on individual workers and institutions.

METHODS

Questionnaires from health care staff of five public health care facilities were collected in 2018 ( n = 1059) and 2021 ( n = 1553). In 2021, 17 workers were interviewed from the same facilities.

RESULTS

Interviewees reported that their organizations struggled to communicate due to changing guidelines, inadequate personal protective equipment, training, and infection control, early in the pandemic. Questionnaire reports of decreased staffing and increased workload during the pandemic were associated with lower baseline NOSACQ scores.

CONCLUSION

Survey findings predicted some variation in organizational response to the pandemic. Better organizational policies for employee safety and pandemic planning could improve health care institutions' preparedness.

Response to NIOSH Request for Information on Interventions to Prevent Work-Related Stress and Support Health Worker Mental Health

The root causes of health care worker strain and depression include excessive job demands, extended work schedules, little decision-making opportunity, assault, bullying, and fear of injury. Potential links between working conditions and opioid overuse have also been discussed, beginning with psychological job strain or with physical pain leading to medication use. Promising solutions have been identified and many would be cost-effective, as enhanced working conditions could improve workers' mental health, job satisfaction, retention, and patient outcomes. Considering the number of health care workers leaving work during the global COVID-19 pandemic, it is urgent to address preventable root causes. In 2021, the US Congress called for educating health workers and first responders on the primary prevention of mental health conditions and substance use disorders. The CDC issued a Request for Information; this submission summarized research from CPH-NEW, a NIOSH Center of Excellence in Total Worker Health®, supplemented by a selective literature review.

Development and Implementation of a Total Worker Health® Mentoring Program in a Correctional Workforce

Correctional officers (COs) are exposed to a number of occupational stressors, and their health declines early in their job tenure. Interventions designed to prevent early decline in CO health are limited. This article describes the development, implementation, and evaluation of a one-year peer health mentoring program (HMP) guided by Total Worker Health® principles and using a participatory action research to collectively address worker safety, health, and well-being of newly hired COs. The HMP aimed to provide new COs with emotional and tangible forms of support during their first year of employment, including peer coaching to prevent early decline in physical fitness and health. The development and implementation of the HMP occurred across five main steps: (1) participatory design focus groups with key stakeholders; (2) adaptation of an existing mentoring handbook and training methods; (3) development of mentor-mentee recruitment criteria and assignment; (4) designing assessment tools; and (5) the initiation of a mentor oversight committee consisting of union leadership, corrections management, and research staff. Correctional employee engagement in the design and implementation process proved to be efficacious in the implementation and adaptation of the program by staff. Support for the HMP remained high as program evaluation efforts continued.