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Musculoskeletal disorders (MSDs) have been recognized as one of the leading causes of workplace injuries. The economic burden of MSDs is estimated to cost up to $54 billion annually. Previous studies have shown that the development of workplace ergonomics interventions could reduce workers’ exposure to physical stress and strain, consequently reducing workers’ risk of developing work-related MSDs. Even with promising results demonstrating efficacy in laboratory-based studies, theoretically sound `changes’ may be resisted or rejected by end users. The long term objective of this research is to improve adoption rates of theoretically sound safety-related changes in the workplace. The underlying hypothesis in this three phase study is that employing structured contemplating activities may result in better acceptance compared to traditional implementation processes. The specific aims of this study were to: 1) Systematically investigate and document how past safety-related workplace changes were implemented from the perspectives of managers and employees, 2) Explore the effect of three types of contemplative implementation approaches to influence an individual’s intention and attitude towards adoption of a safety-related workplace change, 3) Compile an employee version of an `ideal’ introduction-training program to be used when introducing a safety-related change in methods or equipment in a workplace, 4) Share, review (member checking) and validate findings related to Aims 1, 2, and 3 with industrial practitioners, and 5) Investigate how the presented findings and ideas for introduction-training program components might influence the industrial practitioners to possibly reconsider their strategies to introduce workplace safety-related changes in the future. Semi-structured interviews with managers responsible for implementing changes and employees who had experienced receiving changes were used to achieve the first aim. The second aim was achieved through a laboratory-based study that employed group activities, surveys, worksheets, and discussions to explore the effects of contemplative activities that potentially influence intentions and attitudes to adopt an introduced change. The participants’ designs of their `ideal’ introduction-training program were explored using generative method activities (Aim 3). The fourth and fifth aims were addressed through employment of semi-structured interviews with industrial practitioners, in order to share information and validate the outcomes from the previous phases of the study. The findings from the first phase of study provided insights into strategies, approaches, and underlying barriers and facilitators that influence the end-users’ decisions whether or not to adopt an introduced change. Frameworks developed in this phase include the timeline mappings of factor and themes that influence adoption, as well as the key lessons’ learned throughout the workplace change process. In addition, the “leader-follower relationship framework” by Smith (1994) was extended through operationalization of its components from the data extracted in this phase of study. These frameworks could be further developed as visual tools to provide industrial practitioners reminders of parameters to be considered during a workplace intervention implementation process. The second phase of the study documented advantages, disadvantages and improvement suggestions for each of the explored introduction-training approaches. The data also revealed that a single introduction-training approach might not be as effective as the integration of two or three types of approaches, in terms of positively influencing a worker’s intention and attitude towards adoption of an introduced change. The inclusion of the three explored approaches in the Phase 2 participants’ ideal programs verified the initial theoretical assumptions that the contemplative activities explored in this study may have potential to shape a worker’s thought processes during the implementation of a workplace change. An integrated introduction-training framework, representing the study participants’ collective designs, was proposed as multi-element base structure that could be used to organize specific activities as part of the process of introducing workplace changes to employees in practice. In the third phase of the study, the findings from the previous phases of the study, including the integrated introduction-training framework, were shared with and reviewed by experienced safety practitioners. Generally, these experienced practitioners, from a diverse range of industries, and who were located in the US or in Malaysia were in agreement with the findings from phases 1 and 2 of study, which provides a degree of validation of the results. In addition to reviewing results from the first two phases, data gathered from phase 3 participants yielded a compilation of themes and factors that contribute to failure of a change effort, as well as a list of optional activities to be considered in an introduction-training program.The results from this study could be used as a foundation for future intervention research and formulation of guidelines for safety practitioners who are directly responsible for implementation of change efforts. This research provides a bridge between academic research and practice in the area of intervention adoption, and the results could eventually contribute to shaping future intervention efforts, and thereby improve adoption rates of sound ergonomic interventions among intended end-users.

Several publications reported high prevalence of musculoskeletal issues among medical sonographers. Only a few intervention efforts have focused on solving the problem from an engineering control point of view. Echocardiography is a specialty field of ultrasound of the cardiovascular system, and is currently a growing field due to the trends of longer life expectancy and rising obesity levels. Further investigations of cardiac sonographers identified recurring issues such as prolonged probe pinching, forceful exertion, awkward posture and maintaining static posture. This study aims to design an engineering intervention that can potentially reduce these exposure risks. The design process includes observation, interview, literature review, product conceptualization, evaluation and focus group sessions. Cardiac sonographers, engineers, ergonomists, a radiologic sciences professional, and manufacturing technicians were involved in various stages of the design development process. A design of an articulating arm that uses a simple locking mechanism was envisioned to reduce prolonged probe pinching, force exertion, awkward postures, and static postures. A functional prototype was assembled, and pilot tested among cardiac sonographers in a clinic setting. The session revealed the concept's potential in addressing previously identified issues. However, several design iterations and more comprehensive evaluations will be needed before the device will be ready for implementation in echocardiography settings.