Abstract
Background: Evidence supports organizational interventions as being effective for improving worker safety, health and well-being; however, there is a paucity of evidence-based interventions for subcontracting companies in commercial construction. Methods: A theory-driven approach supplemented by formative research through key stakeholder interviews and focus groups and an iterative vetting process with stakeholders, resulted in the development of an intervention for subcontractors in the commercial construction industry. We piloted the intervention in one subcontracting commercial construction company. We used these findings to adapt and finalize the intervention design to be tested in a future large-scale trial. Results: There were several key findings from the formative research, including challenges faced by companies and assets that should be considered in the intervention design. This resulted in a communication infrastructure company-based, continual improvement, participatory intervention design, consisting of a needs assessment and report, committee-led prioritization, action planning and implementation, and worker communication/feedback cycle. The pilot contributed to the final intervention design with modifications made with respect to timing, implementation support, capacity building, adaptability and sustainability. Conclusions: The use of a theory-driven participatory approach to developing an integrated organizational intervention for commercial construction subcontracting companies was important and necessary. It allowed us to consider the empirical evidence and relevant theories and tailor these to meet the needs of our target population. This study gives pragmatic insight into the early development of a complex intervention, with practical experience of how we adapted our intervention at each stage. This intervention will be tested in a future randomized trial.
Highlights
There is a large need to address the high rates of chronic health issues of construction workers through Total Worker Health® (TWH® ) approaches [1], especially those that target the conditions of work [2]
There has been a large emphasis on workplace injury prevention, but little effort addressing other workplace health risk factors through an integrative approach involving ecologic systems-level upstream approaches targeting the conditions of work [2,18]
The aims of this paper are to: (i) present a TWH® intervention design for subcontractor companies in the construction industry that addresses many of the lessons learned from a previous worksite program that we developed for general contractors; (ii) outline the design process that led to this intervention; and (iii) describe the logistic considerations of implementing the intervention with a pilot company
Summary
We piloted the intervention in one subcontracting commercial construction company We used these findings to adapt and finalize the intervention design to be tested in a future large-scale trial. Results: There were several key findings from the formative research, including challenges faced by companies and assets that should be considered in the intervention design. This resulted in a communication infrastructure company-based, continual improvement, participatory intervention design, consisting of a needs assessment and report, committee-led prioritization, action planning and implementation, and worker communication/feedback cycle. Conclusions: The use of a theory-driven participatory approach to developing an integrated organizational intervention for commercial construction subcontracting companies was important and necessary. This intervention will be tested in a future randomized trial
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