Abstract
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.
Highlights
Since the development of the Total Worker Health® (TWH) program led by the NationalInstitute for Occupational Safety and Health (NIOSH) in the United States of America (USA), several guidelines have been created to aid employers in the implementation of integrated interventions that collectively address worker safety, health, and well-being [1,2,3]
The Hierarchy of Controls Applied to NationalInstitute for Occupational Safety and Health (NIOSH) Total Worker Health was published in Fundamentals of Total Worker Health Approaches [2] as a conceptual model designed to aid employers and other professionals interested in implementing workplace safety and health programs aligned with TWH approaches
The overall aim of this study is to explore how the principles of the Hierarchy of Controls Applied to NIOSH Total Worker Health have been implemented among organizations featured as Promising Practices for Total Worker Health [22] between 2012 and 2019, with a special focus on the work-related issues of fatigue, stress, sedentary work, and tobacco control
Summary
Since the development of the Total Worker Health® (TWH) program led by the National.
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