Kevin M Kelly/ March 7, 2017/ Opening/ 5 comments

Defining Characteristics of Total Worker Health®: Issues & Challenges

Anita L. Schill, PhD, MPH, MA, NIOSH, Office of the Director
L. Casey Chosewood, MD MPH, NIOSH, Office for Total Worker Health

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  1. Metrics of integration: Not all of the criteria proposed by NIOSH or by Sorensen et al. are TWH-specific. Some of them (e.g., top leadership commitment) are necessary pre-conditions for any worker safety or health program. Thus, while they are important in that regard, it is debatable whether they are helpful as criteria for defining “integration.”

  2. The original definition of WLI/TWH was very clear. I agree with Anita – it was “elegant.” It was easily understood by practitioners and research partners, and it defined a scope of inquiry that could be used to generate research questions and study designs.
    The new definition has important strengths. It puts the emphasis on up-stream factors in the work environment that impact safety, health, and well-being, and appropriately calls for health-positive policies, practices, and programs.
    However, in the quest to avoid being aligned with traditional wellness programs, we’ve ended up with a definition that no longer clearly distinguishes this program from the rest of the NIOSH portfolio. With all due respect, I think that the long list of topics doesn’t help investigators very much in prioritizing a research agenda for TWH. Could it somehow be divided into sub-categories? Is this something we could discuss this week?

  3. As a general reflection post-meeting, I’d like to recommend that the TWH initiative utilize/consider the NIH PROMIS measures as relevant in particular studies. This is an important measurement initiative that includes scales developed based on item-response theory and enables norm-referenced comparisons.

    Also, when I raised organizational safety climate as an established leading indicator of future occupational injuries, I sensed some skepticism from some participants and we didn’t have time for discussion. On that topic I’d like to submit the following two papers for review/consideration by colleagues:

    Clarke, S. (2006). The relationship between safety climate and safety performance: a meta-analytic review.

    Zohar, D. (2010). Thirty years of safety climate research: Reflections and future directions. Accident Analysis & Prevention, 42(5), 1517-1522.

    Was a great meeting! Thanks to all!

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