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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.Me

Objectives The specific objectives of the 2017 Understanding Small Enterprises Conference were to: (i) identify successful strategies for overcoming occupational safety and health (OSH (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 OSH 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.

The majority of the global labor force works in firms with fewer than 50 employees; firms with fewer than 250 employees make up 99% of workplaces. Even so, the lack of extensive or comprehensive research has failed to focus on occupational safety and health communication to these small- and medium-sized enterprises (SMEs). Given that the magnitude of all occupational safety and health (OSH) morbidity, mortality, and injury disproportionately occurs in businesses with fewer than 250 employees, efforts to communicate with employers to engage in preventative occupational safety and health efforts merit attention. This article provides an overview of important components that should be considered in developing an occupational safety and health (OSH) communication research strategy targeting SMEs. Such a strategy should raise awareness about the diversity and complexity of SMEs and the challenges of targeting OSH communication toward this diverse group. Companies of differing sizes (e.g. 5, 50, 500 employees) likely require differing communication approaches. Communication strategies will benefit from deconstructing the term ‘small business’ into smaller, more homogenous categories that might require approaches. Theory-based research assessing barriers, message content, channels, reach, reception, motivation, and intention to act serve as the foundation for developing a comprehensive research framework. Attention to this type of research by investigators is warranted and should be encouraged and supported. There would also be value in developing national and international strategies for research on communication with small businesses.

Despite its inclusion in models of social and ecological determinants of health, work has not been explored in most health inequity research in the United States. Leaving work out of public health inequities research creates a blind spot in our understanding of how inequities are created and impedes our progress toward health equity. We first describe why work is vital to our understanding of observed societal-level health inequities. Next, we outline challenges to incorporating work in the study of health inequities, including (1) the complexity of work as a concept; (2) work’s overlap with socioeconomic position, race, ethnicity, and gender; (3) the development of a parallel line of inquiry into occupational health inequities; and (4) the dearth of precise data with which to explore the relationships between work and health status. Finally, we summarize opportunities for advancing health equity and monitoring progress that could be achieved if researchers and practitioners more robustly include work in their efforts to understand and address health inequities.

Background Construction is a dangerous industry with a large number of small businesses. Because they require minimal resources to deliver, toolbox talks may be an ideal training format for small construction contractors. Methods Eight toolbox talks were developed, each with two versions. One version of each toolbox talk was standard and one version included a narrative and discussion questions. Participants were randomly assigned to receive the standard or the narrative version. Pre- and post-intervention surveys measured demographics, workplace safety climate, and knowledge. The post-intervention survey also measured training impact. Results Including narratives with discussion questions significantly increased knowledge gain and led to increased training impact. Less experienced workers were more likely to gain knowledge and training impact compared to more experienced workers. There were no significant changes in workplace safety climate. Conclusions The results suggest that including a narrative and discussion questions increases toolbox talk effectiveness.

Action to address workforce functioning and productivity requires a broader approach than the traditional scope of occupational safety and health. Focus on “well-being” may be one way to develop a more encompassing objective. Well-being is widely cited in public policy pronouncements, but often as “. . . and well-being” (e.g., health and well-being). It is generally not defined in policy and rarely operationalized for functional use. Many definitions of well-being exist in the occupational realm. Generally, it is a synonym for health and a summative term to describe a flourishing worker who benefits from a safe, supportive workplace, engages in satisfying work, and enjoys a fulfilling work life. We identified issues for considering well-being in public policy related to workers and the workplace.

A critical step toward advancing research for achieving greater impact on occupational safety and health in small businesses is to have a better understanding of what is meant by the term ‘small business’. The term needs to reflect not only the number of people employed and the financial resources of an enterprise, but also the psychosocial experience of the people that are represented in small businesses. In this article we discuss the role of several dimensions in differentially defining the small business construct, including: number of employees, business age, structure, workforce, manager centricity, and culture. As greater consensus on the small business label is reached, more focused frameworks for small business occupational safety and health research, policy and practice may be developed.

BACKGROUND: Smaller businesses differ from their larger counterparts in having higher rates of occupational injuries and illnesses and fewer resources for preventing those losses. Intervention models developed outside the United States have addressed the resource deficiency issue by incorporating intermediary organizations such as trade associations. METHODS: This paper extends previous models by using exchange theory and by borrowing from the diffusion of innovations model. It emphasizes that occupational safety and health (OSH) organizations must understand as much about intermediary organizations as they do about small businesses. OSH organizations ("initiators") must understand how to position interventions and information to intermediaries as added value to their relationships with small businesses. Examples from experiences in two midwestern states are used to illustrate relationships and types of analyses implied by the extended model. RESULTS: The study found that intermediary organizations were highly attuned to providing smaller businesses with what they want, including OSH services. The study also found that there are opinion leader organizations and individual champions within intermediaries who are key to decisions and actions about OSH programming. CONCLUSIONS: The model places more responsibility on both initiators and intermediaries to develop and market interventions that will be valued in the competitive small business environment where the resources required to adopt each new business activity could always be used in other ways. The model is a candidate for empirical validation, and it offers some encouragement that the issue of sustainable OSH assistance to small businesses might be addressed. Am. J. Ind. Med. 9999:1-10, 2013. Published 2013. This article is a U.S. Government work and is in the public domain in the USA. Language: en

Background Small businesses bear a large burden of injury and death, and are difficult to reach with occupational safety and health (OSH) information. The National Institute for Occupational Safety and Health (NIOSH) developed a pilot study testing the feasibility of fire departments disseminating OSH information to small businesses during fire inspections. Methods Two sets of postcards were developed with unique, trackable URLs for the NIOSH Small Business Resource Guide. One set was distributed by firefighters, the other was mailed to small businesses. Participating inspectors were met with to discuss their experience. Results Neither distribution method resulted in a substantial number of site visits. Inspectors believed distributing postcards was an easy addition to their duties, and saw value in safety information. Conclusions There are barriers beyond awareness of availability that prevent small business owners from seeking OSH information. Research should focus on identifying barriers and developing better OSH information diffusion mechanisms.

Despite differences in approaches to organizational problem solving, healthcare managers and organizational behavior management (OBM) practitioners share a number of practices, and connecting healthcare management with OBM may lead to improvements in patient safety. A broad needs-assessment methodology was applied to identify patient-safety intervention targets in a large rural medical center. This included a content analysis of descriptions of managers' follow-up actions to error reports for nine types of the most frequently occurring errors. Follow-up actions were coded according to the taxonomy of behavioral intervention components developed by Geller et al. (1990). Two error types were identified as targets for intervention, and the outcome of this assessment process indicated a clear need to apply OBM interventions at the management level and thus have a hospital-wide benefit to patient safety. Future implications for using a system-wide approach to identifying and classifying responses to medical er...

Although several organizational behavior management (OBM) intervention techniques have been used to improve designated behaviors related to patient safety, there remains a lack of patient-safety-focused behavioral interventions among healthcare workers. OBM interventions are often applied to needs already identified within an organization, and the means by which these needs are determined vary across applications. The current research addresses gaps in the literature by translating OBM intervention techniques to identify and improve the prevention potential of responses to reported medical errors. A content analysis of 17 months of descriptions of follow-up actions to error reports for nine types of the most-frequently occurring errors was conducted. Follow-up actions were coded according to a taxonomy of behavioral intervention components, with accompanying impact scores based on criteria developed by Geller et al. Two error types were selected for intervention, based on the highest frequency of ...

Injuries from medical sharps devices and blood-borne pathogen (BBP) exposure are a significant risk to many healthcare workers. Risk awareness communications and sharps safety strategies are key components of BBP exposure prevention efforts. The research reported here includes an evaluation of a large-scale communication intervention aimed at raising awareness among healthcare workers regarding the risks of sharps injuries and BBP exposure, as well as methods of prevention. The Stop Sticks campaign was a multi-media communication intervention targeted at multiple healthcare facilities in Columbia, South Carolina. Following a comprehensive needs assessment in each facility, tailored communications were delivered via several channels. Samples included individual hospital departments, an entire hospital, and a nursing home. Results indicate high levels of knowledge and communication channel recall, minimal attitude and behavior change, and a strong association between sharps-related safety behavior a...

Objective To evaluate effects of a natural CPOE implementation in a hospital setting and inform the efficacy of using CPOE rather than traditional paper medication orders. Design A multiple-baseline, quasi-experimental study of a naturally occurring CPOE intervention, with a non-equivalent control site. Measurements Compliance with medication-ordering protocols and time to first dose of antibiotics. Results Medication orders placed using CPOE were significantly more compliant than paper-based medication orders, and first doses of antibiotics were delivered significantly faster when ordered with CPOE than when placed using the standard paper-based system (p Conclusion Findings support the use of CPOE and justify the need for interventions to increase CPOE adoption and consistent use among physicians.

Smaller businesses differ from their larger counterparts in having higher rates of occupational injuries and illnesses and fewer resources for preventing those losses. Intervention models developed outside the United States have addressed the resource deficiency issue by incorporating intermediary organizations such as trade associations.This paper extends previous models by using exchange theory and by borrowing from the diffusion of innovations model. It emphasizes that occupational safety and health (OSH) organizations must understand as much about intermediary organizations as they do about small businesses. OSH organizations ("initiators") must understand how to position interventions and information to intermediaries as added value to their relationships with small businesses. Examples from experiences in two midwestern states are used to illustrate relationships and types of analyses implied by the extended model.The study found that intermediary organizations were highly attuned to providing smaller businesses with what they want, including OSH services. The study also found that there are opinion leader organizations and individual champions within intermediaries who are key to decisions and actions about OSH programming.The model places more responsibility on both initiators and intermediaries to develop and market interventions that will be valued in the competitive small business environment where the resources required to adopt each new business activity could always be used in other ways. The model is a candidate for empirical validation, and it offers some encouragement that the issue of sustainable OSH assistance to small businesses might be addressed. Am. J. Ind. Med. 56:1442-1451, 2013. Published 2013. This article is a U.S. Government work and is in the public domain in the USA.

A study of the effects of fertilizer and herbaceous competition on the survival and growth of spot-seeded oaks and walnut was established in 1979. Species included bur oak (Quercus macrocarpa), pin oak (Q. palustris), white oak (Q. alba), chestnut oak (Q. prinus), and black walnut (Juglans nigra). The treatments consisted of fertilizing with a fertilizer tablet and broadcast seeding a grass and legume mixture. All test plots were mulched with a mixture of composted sewage sludge and hardwood bark. Initial stocking of all oaks was better than 60 percent, but by the end of the sixth growing season, only bur oak had maintained a stocking level that was considered successful (70 percent). Stocking of the other oaks and walnut dropped to less than 20 percent. Evaluation of the bur oaks after 10 growing seasons showed that the saplings in the fertilizer plots had grown significantly taller than those in the other treatments; average height was 176 cm. Poorest growth was in the fertiliser plus grass plu...