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Leso V, Carugno M, Carrer P, Fusco F, Mendola M, Coppola M, Zaffina S, Di Prinzio RR, Iavicoli I. The Total Worker Health® (TWH) approach: a systematic review of its application in different occupational settings. BMC Public Health 2024; 24:2037. [PMID: 39080673 PMCID: PMC11287918 DOI: 10.1186/s12889-024-19500-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Accepted: 07/16/2024] [Indexed: 08/03/2024] Open
Abstract
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.
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Affiliation(s)
- Veruscka Leso
- Department of Public Health, Section of Occupational Medicine, University of Naples Federico II, Via S. Pansini 5, 80131, Naples, Italy
| | - Michele Carugno
- Department of Clinical Sciences and Community Health, University of Milan, Via San Barnaba 8, 20122, Milan, Italy
- Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via San Barnaba 8, 20122, Milan, Italy
| | - Paolo Carrer
- Occupational Health Unit, Fatebenefratelli-Sacco University Hospital, Via G.B. Grassi 74, 20157, Milan, Italy
- Department of Biomedical and Clinical Sciences, University of Milan, Via G.B. Grassi 74, 20157, Milan, Italy
| | - Fabio Fusco
- Department of Public Health, Section of Occupational Medicine, University of Naples Federico II, Via S. Pansini 5, 80131, Naples, Italy
| | - Marco Mendola
- Occupational Health Unit, Fatebenefratelli-Sacco University Hospital, Via G.B. Grassi 74, 20157, Milan, Italy
| | - Mariagaia Coppola
- Department of Public Health, Section of Occupational Medicine, University of Naples Federico II, Via S. Pansini 5, 80131, Naples, Italy
| | - Salvatore Zaffina
- Occupational Medicine Unit, IRCCS Bambino Gesù Children's Hospital, Piazza S.Onofrio, 4, Rome, 00165, Italy
| | - Reparata Rosa Di Prinzio
- Occupational Medicine Unit, IRCCS Bambino Gesù Children's Hospital, Piazza S.Onofrio, 4, Rome, 00165, Italy
- Alta Scuola Di Economia E Management Dei Sistemi Sanitari (ALTEMS), Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, Rome, 00168, Italy
| | - Ivo Iavicoli
- Department of Public Health, Section of Occupational Medicine, University of Naples Federico II, Via S. Pansini 5, 80131, Naples, Italy.
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Peters SE, López Gómez MA, Hendersen G, Martínez Maldonado M, Dennerlein J. Feasibility of a Capacity Building Organizational Intervention for Worker Safety and Well-being in the Transportation Industry: Pivoting to Address the COVID-19 Pandemic and Social and Political Unrest in Chile. J Occup Environ Med 2024; 66:e272-e284. [PMID: 38595081 DOI: 10.1097/jom.0000000000003112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
OBJECTIVE This study developed, implemented, and evaluated the feasibility of executing an organizational capacity building intervention to improve bus driver safety and well-being in a Chilean transportation company. Method: Through an implementation science lens and using a pre-experimental mixed methods study design, we assessed the feasibility of implementing a participatory organizational intervention designed to build organizational capacity. Result: We identified contextual factors that influenced the intervention mechanisms and intervention implementation and describe how the company adapted the approach for unexpected external factors during the COVID-19 pandemic and social and political unrest experienced in Chile. Conclusions: The intervention enabled the organization to create an agile organizational infrastructure that provided the organization's leadership with new ways to be nimbler and more responsive to workers' safety and well-being needs and was robust in responding to strong external forces that were undermining worker safety and well-being.
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Affiliation(s)
- Susan E Peters
- From the Center for Work, Health, and Well-being, Harvard T.H. Chan School of Public Health, Boston, Massachusetts (S.E.P., J.D.); Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts (S.E.P.); Sociology Department, Memorial University of Newfoundland, St. John's, NL, Canada (M.-A.L.G.); Center for Demographic Studies (CED), CED-CERCA, Barcelona, Spain (M.-A.L.G.); College of Osteopathic Medicine, University of New England, Biddeford, Maine (G.H.); Subgerencia de Innovación e Investigación, Mutual de Seguridad CChC, Santiago, Chile (M.M.M.); and Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts (J.D.)
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McAden EP, Leff MS, Staley JA, Greenberg RW, Nylander-French LA, Linnan LA. Feasibility of Implementing a Total Worker Health® Intervention During the COVID-19 Pandemic in Small and Medium Businesses : Results From the Carolina PROSPER Study. J Occup Environ Med 2023; 65:880-889. [PMID: 37550988 DOI: 10.1097/jom.0000000000002935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
OBJECTIVE In response to the COVID-19 pandemic's disruptive effect on employers and workers, an interdisciplinary team launched the Carolina Promoting Safe Practices for Employees' Return study to assess the feasibility of providing tailored technical assistance to small and medium North Carolina businesses using a Total Worker Health (TWH) ® approach. METHODS Feasibility of the approach was assessed via surveys and interviews of business representatives from four participating businesses ranging in size from 3 to 110 employees. RESULTS The TWH approach is feasible, that is, in demand, practical, and acceptable to protect and promote worker safety, health, and well-being. Potential challenges include implementation cost, difficulty engaging all employees, and difficulty accessing tailored health and safety materials in a timely manner. CONCLUSIONS Additional refinement and testing of the TWH approach postpandemic with more worksites is warranted.
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Affiliation(s)
- Emily P McAden
- From the North Carolina Occupational Safety and Health Education and Research Center, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (E.P.M., J.A.S., R.W.G., L.A.N.-F.); Department of Health Behavior, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (M.S.L., L.A.L.); Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (J.A.S., L.A.N.-F.); and The Center for Construction Research and Training, Silver Spring, Maryland (R.W.G.)
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Reynolds GS, Bennett JB. The Role of Wellness Climate in Small Business Health Promotion and Employee Wellbeing. OCCUPATIONAL HEALTH SCIENCE 2023:1-36. [PMID: 37359456 PMCID: PMC10131546 DOI: 10.1007/s41542-023-00148-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 03/08/2023] [Accepted: 03/27/2023] [Indexed: 06/28/2023]
Abstract
Wellness involves physical, emotional, behavioral, social, and spiritual dimensions. A climate for wellness exists at both the psychological and organizational levels, consisting of individual and shared perceptions of policies, structures, and managerial behavior that support or promote employee wellbeing. This study explored the associations between psychological and organizational wellness climate and the effectiveness of a team health promotion training on employees' perceived physical and mental wellbeing and substance use. Employees from 45 small businesses completed self-report measures of wellness climate, wellbeing, positive unwinding behavior, work-family conflict, job stress, drug use, and alcohol use, assessed before, and one and six months after, attending either of two types of onsite health promotion training. Team Awareness training targeted improvements in the social climate at work. Healthy Choices training targeted individual health behavior. A control group did not receive training until after the study. Businesses were randomly assigned to conditions and data were analyzed using multi-level modeling. Models that included wellness climate as a mediator fit the data significantly better than models without climate as a mediator. Team Awareness participants showed greater improvements in wellness climate and wellbeing compared to the control group. Healthy Choices participants showed no changes in climate and no mediation effects of climate. Health promotion efforts may be enhanced by including wellness climate as a target in program design at multiple levels.
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Affiliation(s)
- G. Shawn Reynolds
- Organizational Wellness & Learning Systems, 2221 Justin Rd. #119485, Flower Mound, TX 75028 USA
| | - Joel B. Bennett
- Organizational Wellness & Learning Systems, 2221 Justin Rd. #119485, Flower Mound, TX 75028 USA
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Rinsky-Halivni L, Brammli-Greenberg S, Christiani DC. Ageing workers' mental health during COVID-19: a multilevel observational study on the association with the work environment, perceived workplace safety and individual factors. BMJ Open 2022; 12:e064590. [PMID: 36572502 PMCID: PMC9805828 DOI: 10.1136/bmjopen-2022-064590] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 12/07/2022] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES The stress and anxiety associated with the predisposition of ageing workers to severe COVID-19 illness, once occupationally infected, jeopardise their mental health. This study aimed to investigate the association between individual level, work environment exposure factors and perceived workplace safety with a decline in mental health of ageing workers from different industry sectors. DESIGN Observational study, prevalence assessment of survey added to longitudinal cohort data. SETTING The Survey of Health, Ageing and Retirement in Europe (SHARE) from 27 countries in Europe and Israel participating in the COVID-19 survey (summer 2020) and having prepandemic waves' SHARE data. PARTICIPANTS Workers aged 50-70 (n=6449) who attended their workplaces at least partially after the pandemic broke out. PRIMARY OUTCOME MEASURE Perceived decline in mental health compared with preoutbreak status. RESULTS Multilevel analyses demonstrated that 24.5% (95% CI 23.5% to 25.5%) of ageing workers in Europe experienced mental health decline associated with national-level self-reported COVID-19 burden. Workplace safety perception was the strongest predictor, as each one-point increase in unsafe perception was associated with 60% of mental health decline (OR=1.6, 95% CI 1.47 to 1.74), explaining 30% of increased reported mental health symptoms of ageing workers. Safety perception mediates the mental health outcomes of the work environment, such as workplace contagion risk and work location. Female gender (OR=1.77, 95% CI 1.55 to 2.02), financial difficulties (OR=1.19, 95% CI 1.1 to 1.28), higher vulnerability index (comorbidities, age >60) (OR=1.11, 95% CI 1.05 to 1.18), pre-existing mental problems (OR=1.78, 95% CI 1.55 to 2.04) and increased national burden of COVID-19 (OR=1.01, 95% CI 1.0 to 1.02) were associated with declines in mental health, whereas exclusively working on-site was protective. CONCLUSION Vulnerable subgroups for mental health declines among ageing workers were revealed, which warrant their screening and employers' evaluation of workplace conditions of ageing workers to prevent mental health-related implications. Workplace interventions should aim to reduce work environment influences on infection risk and mental distress.
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Affiliation(s)
- Lilah Rinsky-Halivni
- Takemi Program in International Health, Department of Global Health and Population, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
- Braun School of Public Health, Faculty of Medicine, The Hebrew University, Jerusalem, Israel
| | - Shuli Brammli-Greenberg
- Braun School of Public Health, Faculty of Medicine, The Hebrew University, Jerusalem, Israel
| | - David C Christiani
- Environmental Health, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
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Tamers SL, Streit JMK, Chosewood C. Promising Occupational Safety, Health, and Well-Being Approaches to Explore the Future of Work in the USA: An Editorial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1745. [PMID: 35162768 PMCID: PMC8834959 DOI: 10.3390/ijerph19031745] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 01/30/2022] [Indexed: 01/09/2023]
Abstract
The future of work continues to undergo profound and fundamental changes in response to shifting social, technological, economic, environmental, and political contexts [...].
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Affiliation(s)
- Sara L. Tamers
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, 395 E Street SW, Washington, DC 20201, USA
| | - Jessica M. K. Streit
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, 1090 Tusculum Avenue, Cincinnati, OH 45226, USA;
| | - Casey Chosewood
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, 1600 Clifton Rd., Atlanta, GA 30329, 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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