scholarly journals An Exploratory, Qualitative Study of How Organizations Implement the Hierarchy of Controls Applied to Total Worker Health®

2021 ◽  
Vol 18 (19) ◽  
pp. 10032
Author(s):  
Heidi L. Hudson ◽  
Anita L. Schill ◽  
Reid Richards
Keyword(s):  
Well Being ◽  
Lessons Learned ◽  
Worker Safety ◽  
Special Focus ◽  
Specific Work ◽  
Implementation Climate ◽  
Cross Sectional ◽  
Work Related ◽  
Worker Health ◽  
Total Worker Health

Understanding of how Total Worker Health® (TWH) guidelines are implemented in employment organizations in the USA is not well understood. The purpose of this study is to explore how the principles of the Hierarchy of Controls Applied to NIOSH Total Worker Health (TWH HoC), have been implemented among organizations featured as Promising Practices for TWH between 2012–2019, with special focus on the work-related issues of fatigue, stress, sedentary work, and tobacco control. We also sought to identify benefits, obstacles, and lessons learned in the implementation of the TWH HoC. Eighteen organizations were identified to be included in the study. Using a qualitative cross-sectional design and purposive sampling, seven in-depth interviews were conducted with thirteen key informants. The Consolidated Framework for Implementation Research was used to guide the thematic analysis and interpretation of qualitative data. Four themes identified include recognition of the TWH approach and TWH HoC, implementation of the TWH HoC, barriers and facilitators in addressing specific work-related issues, and implementation climate primes benefits, obstacles, and lessons learned. The inner setting (i.e., culture, implementation climate, readiness for implementation) of organizations was a prominent determinant of the implementation of integrated worker safety, health, and well-being interventions.

scholarly journals Total Worker Health® 2014–2018: The Novel Approach to Worker Safety, Health, and Well-Being Evolves

2019 ◽  
Vol 16 (3) ◽  
pp. 321 ◽  
Author(s):  
Sara Tamers ◽  
L. Chosewood ◽  
Adele Childress ◽  
Heidi Hudson ◽  
Jeannie Nigam ◽  
...  
Keyword(s):  
Occupational Safety ◽  
Well Being ◽  
Worker Safety ◽  
Work Related ◽  
Worker Health ◽  
Novel Approach ◽  
Safety And Health ◽  
Building Information ◽  
Health And Well Being ◽  
Total Worker Health

Background: The objective of this article is to provide an overview of and update on the Office for Total Worker Health® (TWH) program of the Centers for Disease Control and Prevention’s National Institute for Occupational Safety and Health (CDC/NIOSH). Methods: This article describes the evolution of the TWH program from 2014 to 2018 and future steps and directions. Results: The TWH framework is defined as policies, programs, and practices that integrate protection from work-related safety and health hazards with promotion of injury and illness prevention efforts to advance worker well-being. Conclusions: The CDC/NIOSH TWH program continues to evolve in order to respond to demands for research, practice, policy, and capacity building information and solutions to the safety, health, and well-being challenges that workers and their employers face.

scholarly journals Ethics and Total Worker Health®: Constructs for Ethical Decision-Making and Competencies for Professional Practice

2021 ◽  
Vol 18 (19) ◽  
pp. 10030
Author(s):  
Bonnie Rogers ◽  
Anita L. Schill
Keyword(s):  
Decision Making ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Ethical Issues ◽  
Ethical Dilemmas ◽  
Well Being ◽  
Work Hours ◽  
Worker Safety ◽  
Worker Health ◽  
Total Worker Health

Work has become increasingly technologically driven and fast paced, with long work hours, new/emerging hazards, and rising health care costs. Threats to worker safety, health, and well-being including non-traditional work arrangements and practices, precarious work, uncertain hazardous exposures, and work organization issues, such as heavy workloads, design of work, uneven work hours, and difficult interpersonal relationships among workers and managers are apparent. Furthermore, the relationship between personal health risk factors and workplace risks and exposures has drawn increased attention and concern. As employer economic pressures continue to build, it is anticipated that ethical dilemmas for practitioners will become increasingly complex. A review of relevant Total Worker Health (TWH) literature, related ethical constructs and competencies, an examination of codes of ethics for occupational safety and health and health promotion/education disciplines was conducted. A case study for TWH utilizing an ethical decision-making model for the analysis of key ethical issues and solutions was completed. TWH approaches to protecting safety, promoting health, and advancing well-being are increasingly being adopted. These approaches can reveal ethical dilemmas, and ethical constructs are needed to guide decision-making. A core set of proposed ethical competencies for TWH professionals are identified as a transdisciplinary framework to support workplace ethical culture.

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

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Suzanne Nobrega ◽  
Cesar Morocho ◽  
Michelle M. Robertson ◽  
Alicia Kurowski ◽  
Serena Rice ◽  
...  
Keyword(s):  
Mixed Method ◽  
Research Team ◽  
Well Being ◽  
Organizational Readiness ◽  
Worker Safety ◽  
Feedback Report ◽  
Readiness Assessment ◽  
Content Type ◽  
Worker Health ◽  
Total Worker Health

PurposeTotal Worker Health® (TWH) programs, which represent a holistic approach for advancing worker safety, health and well-being, require an employer to adapt programmatic coordination and employee involvement in program design and delivery. Organizational readiness for such measures requires competencies in leadership, communication, subject expertise and worker participation. In the absence of documented methods for TWH readiness assessment, the authors developed a process to prospectively identify implementation facilitators and barriers that may be used to strengthen organizational competencies and optimize the organizational “fit” in advance.Design/methodology/approachThe mixed-method baseline assessment instruments comprised an online organizational readiness survey and a key leader interview; these were administered with key organizational and labor leaders in five US healthcare facilities. Findings about organizational resources, skills available and potential implementation barriers were summarized in a stakeholder feedback report and used to strengthen readiness and tailor implementation to the organizational context.FindingsThe research team was able to leverage organizational strengths such as leaders' commitment and willingness to address nontraditional safety topics to establish new worker-led design teams. Information about program barriers (staff time and communication) enabled the research team to respond with proactive tailoring strategies such as training on participant roles, extending team recruitment time and providing program communication tools and coaching.Originality/valueA new method has been developed for prospective organizational readiness assessment to implement a participatory TWH program. The authors illustrate its ability to identify relevant organizational features to guide institutional preparation and tailor program implementation.

scholarly journals Advancing Well-Being Through Total Worker Health®

2017 ◽  
Vol 65 (4) ◽  
pp. 158-163 ◽  
Author(s):  
Anita L. Schill
Keyword(s):  
Well Being ◽  
Health Hazards ◽  
Work Related ◽  
Worker Health ◽  
Illness Prevention ◽  
Safety And Health ◽  
Paradigm Shifting ◽  
Health And Well Being ◽  
Total Worker Health

Total Worker Health® (TWH) is a paradigm-shifting approach to safety, health, and well-being in the workplace. It is defined as policies, programs, and practices that integrate protection from work-related safety and health hazards with promotion of injury and illness prevention efforts to advance worker well-being. The most current TWH concepts are presented, including a description of issues relevant to TWH and introduction of a hierarchy of controls applied to TWH. Total Worker Health advocates for a foundation of safety and health through which work can contribute to higher levels of well-being.

scholarly journals Defining ‘Integration’ for Total Worker Health®: A New Proposal

2020 ◽  
Vol 64 (3) ◽  
pp. 223-235 ◽  
Author(s):  
Laura Punnett ◽  
Jennifer M Cavallari ◽  
Robert A Henning ◽  
Suzanne Nobrega ◽  
Alicia G Dugan ◽  
...  
Keyword(s):  
Health Promotion ◽  
Occupational Safety ◽  
Well Being ◽  
Occupational Safety And Health ◽  
Worker Safety ◽  
Workplace Health ◽  
Worker Health ◽  
Safety And Health ◽  
Building Program ◽  
Total Worker Health

Abstract The effects of work and the conditions of employment on health behaviors and intermediate health conditions have been demonstrated, to the extent that these relationships should be addressed in efforts to prevent chronic disease. However, conventional health promotion practice generally focuses on personal risk factors and individual behavior change. In an effort to find solutions to the myriad of health challenges faced by the American workforce, the U.S. National Institute for Occupational Safety and Health (NIOSH) established the Total Worker Health® (TWH) program. Originally organized around the paradigm of integrating traditional occupational safety and health protections with workplace health promotion, TWH has evolved to a broader emphasis on workplace programs for enhancing worker safety, health, and well-being. Among the research programs and approaches developed by investigators at NIOSH Centers of Excellence for TWH and elsewhere, definitions of ‘integration’ in workplace interventions vary widely. There is no consensus about which organizational or individual outcomes are the most salient, how much to emphasize organizational contexts of work, or which program elements are necessary in order to qualify as ‘Total Worker Health’. Agreement about the dimensions of integration would facilitate comparison of programs and interventions which are self-defined as TWH, although diverse in content. The specific criteria needed to define integration should be unique to that concept—i.e. distinct from and additive to conventional criteria for predicting or evaluating the success of a workplace health program. We propose a set of four TWH-specific metrics for integrated interventions that address both program content and process: (i) coordination and interaction of workplace programs across domains; (ii) assessment of both work and non-work exposures; (iii) emphasis on interventions to make the workplace more health-promoting; and (iv) participatory engagement of workers in pivotal ways during intervention prioritization and planning to develop self-efficacy in addressing root causes, skill transfer, building program ownership, empowerment, and continuous improvement. Thus we find that integration requires organizational change, both to engage two managerial functions with different goals, legal responsibilities, and (often) internal incentives & resources, and also to orient the organization toward salutogenesis. Examples from research activity within the Center for the Promotion of Health in the New England Workplace illustrate how these criteria have been applied in practice.

scholarly journals Total worker health® is the future of worker safety, health, and well-being

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Tamers
Keyword(s):  
Occupational Safety ◽  
Well Being ◽  
Occupational Safety And Health ◽  
Worker Safety ◽  
Future Of Work ◽  
Worker Health ◽  
Safety And Health ◽  
The Future ◽  
Health And Well Being ◽  
Total Worker Health

Abstract The future of work is being shaped by rapid changes in the workplace, work, and workforce. Driven by advances in industry, this movement is marked by the accelerated pace of developments connecting people, places, and things. All these advances and developments have implications for worker safety, health, and well-being and require innovative occupational safety and health strategies. Because of these new realities, the U.S. Centers for Disease Control and Prevention's (CDC) National Institute for Occupational Safety and Health (NIOSH) recently launched the Future of Work (FOW) Initiative. This Initiative is a collaborative effort of multidisciplinary research, communication, and partnerships throughout NIOSH, other agencies, and organizations that aims to identify novel research solutions, practical approaches, and partnership opportunities to address the future of work. To more broadly address worker safety, health, and well-being, the FOW Initiative applies the Total Worker Health® (TWH) framework. TWH is defined as policies, programs, and practices that integrate protection from work-related safety and health hazards with promotion of injury and illness prevention efforts to advance worker well-being. The TWH approach prioritizes changes to improve physical, organizational, and psychosocial factors that present possible risks in the work environment for today's and tomorrow's workforce. This presentation will first introduce CDC/NIOSH's FOW Initiative. Next, the TWH integrated approach will be defined and described. Centering on CDC/NIOSH's future of work priority topics in the areas of workplace (organizational design, technological displacement, work arrangements), work (artificial intelligence, robotics, technologies), and workforce (demographics, economic security, skills), the presenter will then provide evidence-based solutions to address future of work issues and related outcomes, using the TWH approach. Key messages The future of work has world-wide implications for the workplace, work, workforce. The Total Worker Health framework is a transdisciplinary approach by which to view and address the future of work. Public health professionals and other stakeholders must take a proactive approach to address worker safety, health, and well-being issues impacted by the future of work.

scholarly journals Using Total Worker Health® Implementation Guidelines to Design an Organizational Intervention for Low-Wage Food Service Workers: The Workplace Organizational Health Study

2021 ◽  
Vol 18 (17) ◽  
pp. 9383
Author(s):  
Eve M. Nagler ◽  
Elisabeth A. Stelson ◽  
Melissa Karapanos ◽  
Lisa Burke ◽  
Lorraine M. Wallace ◽  
...  
Keyword(s):  
Working Conditions ◽  
Food Service ◽  
Well Being ◽  
Worker Safety ◽  
Organizational Intervention ◽  
Service Workers ◽  
Worker Health ◽  
Implementation Guidelines ◽  
Food Service Workers ◽  
Total Worker Health

Total Worker Health® (TWH) interventions that utilize integrated approaches to advance worker safety, health, and well-being can be challenging to design and implement in practice. This may be especially true for the food service industry, characterized by high levels of injury and turnover. This paper illustrates how we used TWH Implementation Guidelines to develop and implement an organizational intervention to improve pain, injury, and well-being among low-wage food service workers. We used the Guidelines to develop the intervention in two main ways: first, we used the six key characteristics of an integrated approach (leadership commitment; participation; positive working conditions; collaborative strategies; adherence; data-driven change) to create the foundation of the intervention; second, we used the four stages to guide integrated intervention planning. For each stage (engaging collaborators; planning; implementing; evaluating for improvement), the Guidelines provided a flexible and iterative process to plan the intervention to improve safety and ergonomics, work intensity, and job enrichment. This paper provides a real-world example of how the Guidelines can be used to develop a complex TWH intervention for food service workers that is responsive to organizational context and addresses targeted working conditions. Application of the Guidelines is likely transferable to other industries.

scholarly journals Correction Workers’ Burnout and Outcomes: A Bayesian Network Approach

2019 ◽  
Vol 16 (2) ◽  
pp. 282 ◽  
Author(s):  
Jin Lee ◽  
Robert Henning ◽  
Martin Cherniack
Keyword(s):  
Network Analysis ◽  
Bayesian Network ◽  
Well Being ◽  
The United States ◽  
Contributing Factors ◽  
Work Related ◽  
Worker Health ◽  
Primary Driver ◽  
Joint Consideration ◽  
Total Worker Health

The present study seeks to demonstrate how Bayesian Network analysis can be used to support Total Worker Health® research on correction workers by (1) revealing the most probable scenario of how psychosocial and behavioral outcome variables in corrections work are interrelated and (2) identifying the key contributing factors of this interdependency relationship within the unique occupational context of corrections work. The data from 353 correction workers from a state department of corrections in the United States were utilized. A Bayesian Network analysis approach was used to probabilistically sort out potential interrelations among various psychosocial and behavioral variables. The identified model revealed that work-related exhaustion may serve as a primary driver of occupational stress and impaired workability, and also that exhaustion limits the ability of correction workers to get regular physical exercise, while their interrelations with depressed mood, a lack of work engagement, and poor work-family balance were also noted. The results suggest the importance of joint consideration of psychosocial and behavioral factors when investigating variables that may impact health and wellbeing of correction workers. Also, they supported the value of adopting the Total Worker Health® framework, a holistic strategy to integrate prevention of work-related injury and illness and the facilitation of worker well-being, when considering integrated health protection and promotion interventions for workers in high-risk occupations.

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

2021 ◽  
Vol 18 (16) ◽  
pp. 8712
Author(s):  
Sara Namazi ◽  
Rajashree Kotejoshyer ◽  
Dana Farr ◽  
Robert A. Henning ◽  
Diana C. Tubbs ◽  
...  
Keyword(s):  
Employee Engagement ◽  
Participatory Design ◽  
Correctional Officers ◽  
Well Being ◽  
Assessment Tools ◽  
Worker Safety ◽  
Mentoring Program ◽  
Training Methods ◽  
Worker Health ◽  
Total Worker Health

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.

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