Charting the Path to Total Worker Health™: A Practitioner’s Guide to Getting Started

August 22, 2014

HPLive.org Webinars

The findings and conclusions in this presentation have not been formally disseminated by the National Institute for Occupational Safety and Health, and

should not be construed to represent any agency determination or policy

LCDR Heidi Hudson, MPH

Office for Total Worker HealthTM

National Institute for Occupational Safety and Health

Nicole Champagne, EdD University of Massachusetts Lowell

The Promotion of Health in the New England Workplace

Dede Montgomery, MS, CIH Oregon Health & Science University Oregon Healthy WorkForce Center

Jennifer Hall, EdD

University of Iowa Healthier Workforce Center for Excellence

Jack Dennerlein, PhD Northeastern University

Harvard Center for Work, Health and Wellbeing

Featured Presenters

• OSHA Act of 1970. SEC. (2) (b) . . . “to assure so far as possible every working man and woman in the Nation safe and healthful working conditions and to preserve our human resources . . .”

• NIOSH mission: “generate new knowledge in the field of occupational safety and health and to transfer that knowledge into practice for the betterment of workers.” – Scientific research, guidance and authoritative

recommendations, information dissemination, and workplace health hazard evaluations

• NIOSH is dedicated to preserving and enhancing the Total Health of Workers

The Total Worker Health™ Approach

Total Worker Health™ is a strategy integrating occupational safety and health protection with health promotion to prevent worker injury and illness and to advance health and well-being.

Center for the Promotion of Health in the New England

Workplace (CPH-NEW)

Harvard School of Public Health

Center for Work, Health and Wellbeing

Oregon Healthy

WorkForce Center

(OHWC)

University of Iowa Healthier Workforce Center for Excellence

(HWCE)

5

Example of Integration

An example: Providing ergonomic consultations for work conditions within interventions that also include arthritis self-management strategies

6

http://www.cdc.gov/niosh/twh/letsgetstarted.html

Making the Business Case http://www.cdc.gov/niosh/twh/business.html

• Why Do I Need to Integrate Health Protection and Health Promotion?

• How Can It Help My Business or Workplace?

• Future Steps

Infographic: Top Reasons to Create a New Pathway for a Safer and Healthier Workforce

http://www.cdc.gov/niosh/twh/topreasons/

Simple Steps to Get Started http://www.cdc.gov/niosh/twh/steps.html

1. NIOSH Essential Elements of Effective Workplace Programs and Policies for Improving Worker Health and Wellbeing

2. Ideas You Can Implement Right Now to Integrate Health Protection and Health Promotion

3. Worksheet to Help You Get Started on Program Design, Implementation, and Evaluation

Assessment Tools http://www.cdc.gov/niosh/twh/tools.html

1. Integration of Health Protection and Health Promotion: Rationale, Indicators, and Metrics (Sorensen et al, 2013)

2. CDC Worksite Health ScoreCard (HSC)

3. NIOSH Organization of Work Measurement Tools for Research and Practice

4. NIOSH Quality of Worklife Questionnaire

5. Occupational Safety and Health Administration (OSHA) Form 33

6. American College of Occupational and Environmental Medicine’s Corporate Health Achievement Award

7. CDC Workplace Health Assessment

Guidelines for Integrated Approaches http://www.cdc.gov/niosh/twh/tools.html

1. The Whole Worker: Guidelines for Integrating Occupational health and Safety with Workplace Wellness Programs, State of California Commission on Health and Safety and Workers’ Compensation (CHSWC); 2010

2. Healthy Workplace Participatory Program by Center for Promotion and Health in the New England Workplace (CPH-NEW); 2013

3. SafeWell Practice Guidelines: An Integrated Approach to Worker Health Version 2.0 by the Harvard School of Public Health, Center for Work, Health, and Well-Being; 2012

Organizations Advancing Integrated Approaches: Promising Practices for Total Worker Health

http://www.cdc.gov/niosh/twh/practices.html

Experience Total Worker Health live and in-person!

www.eagleson.org/twh

www.eagleson.org/hfw

Stay Connected

For the latest news on Total Worker Health

Sign up for our quarterly eNewsletter, TWH in Action!

http://www.cdc.gov/niosh/TWH/newsletter/

Join the Conversation!

Follow us Twitter @NIOSH_TWH

Join the NIOSH Total Worker Health Group on LinkedIn

Email us at TWH@cdc.gov

Breakout Session

2014 Iowa Governor’s Safety & Health Conference

Cedar Rapids, IA ; November 7, 2013

Charting the Path to Total Worker Health™: A Practitioner’s Guide to Getting Started

August 22, 2014

Presented by:

Jenny Hall, EdD, MCHES

Associate Director for Outreach

UI Healthier Workforce Center for Excellence

jennifer-l-hall@uiowa.edu

HWCE Resources for a Healthier & Safer Workforce

www.hwce.org

Purpose & Outline

• Introduce the University of Iowa Healthier Workforce Center for Excellence (HWCE)

• Provide an overview of HWCE online resources for implementing workplace programs on issues relevant to Total Worker Health™

www.hwce.org

NIOSH Total Worker Health™ Centers of Excellence

Mission: Improve the health of workers in Iowa and

nationally through integrated health promotion and health

protection research, collaboration, and dissemination of

successful interventions.

Outreach Program Goals

Identify and promote Total Worker Health™ best and promising practices

Serve as a state and national resource center for integrated employee health, wellness and safety programs, practices and policies

Target small employers and those with limited resources

UIHWCE

www.hwce.org

HWCE Online Resources

The HWCE is committed to providing employers with online, evidence-based information and tools to help build a healthier and safer workforce.

Monthly Healthier Workforce eBulletin

HWCE Website

Calendar of Events & Professional Development Opportunities

Social Media Channels

Pinterest

Twitter

Facebook

Videos (video series will be available in 2015)

www.hwce.org

Monthly eBulletin

Sign up at www.hwce.org

We translate research and promote promising practices in comprehensive, integrated workplace safety and wellness programs. Bulletin topics guide web content, tools and resources.

HWCE Website

www.hwce.org

New and improved website will launch by October 1, 2014

www.hwce.org

Program Support

www.hwce.org

Background & Relevance

www.hwce.org

Workplace Programs

www.hwce.org

Ideas for Implementation

www.hwce.org

More Ideas for Implementation

www.hwce.org

TWH Considerations

www.hwce.org

Total Worker Health Approaches

www.hwce.org

Resources & Supporting Literature

www.hwce.org

Future Topics for Bulletins & Website

Aging Workforce

Diabetes

Financial Literacy

Mental Health (depression and anxiety)

Musculoskeletal Disorders

Stress Management Programs and Activities

Work-Life Balance

www.hwce.org

Presentations & Publications

www.hwce.org

HWCE Current Website

Sign-up at www.hwce.org to stay connected and receive notice of official website launch www.hwce.org

Current Program Support

www.hwce.org

HWCE on Pinterest

www.hwce.org

Follow Iowa Total Worker Health on Pinterest

HWCE on Facebook & Twitter

Follow us @UIHWCE on Twitter

Like the “Healthier Workforce Center for Excellence” on Facebook

www.hwce.org

Employer Tip of the Week

Shared through Twitter @UIHWCE and Facebook (Healthier Workforce Center for Excellence)

www.hwce.org

In Closing…

Get Connected with the HWCE

Sign up for the HWCE Healthier Workforce eBulletin at www.hwce.org

Follow us on Twitter @UIHWCE

Like us on Facebook at Healthier Workforce Center for Excellence

Follow us on Pinterest at Iowa Total Worker Health

Join us at upcoming conferences

1st International Symposium to Advance Total Worker Health in Bethesda, MD on Oct. 6-8, 2014

2nd Annual Quad Cities Health Initiative Wellness Conference in Bettendorf, IA on Nov 4, 2014

25th Annual Art & Science of Health Promotion: What’s Next in Health

Promotion? in San Diego, CA on April 1-3, 2014

www.hwce.org

For More Information…

Contact:

Jenny Hall, EdD, MCHES

Associate Director for Outreach

jennifer-l-hall@uiowa.edu

319-335-4200

www.hwce.org

www.uml.edu/centers/CPH-NEW

CPH-NEW Healthy Workplace

Participatory Program Toolkit A new online toolkit to improve the health, safety, and wellbeing in

the workplace

How your organization will benefit?

http://bit.ly/18yrMv8

Why a participatory approach?

http://bit.ly/1dLNqOv

The science behind the program.

http://bit.ly/IBtgIT

Presenter:

Nicole Champagne, Ed.D.

University of MA Lowell

www.uml.edu/centers/CPH-NEW

Healthy Worksite Training Series

Introduction to the Healthy Worksite website

Get ready for program start-up

Build your program team

Data and assessment

Using the IDEAS tool for participatory intervention planning: steps 1 and 2

Using the IDEAS tool: steps 3, 4, 5

Using the IDEAS tool: step 6, 7 and evaluation

http://www.uml.edu/Research/Centers/CPH-NEW/Healthy-Work-

Participatory-Program/Webinars.aspx

www.uml.edu/centers/CPH-NEW

Implement and evaluate models for improving worker health

by combining:

• Worksite health promotion (WHP)

• Workplace safety and health (OSH)

Promote participatory approaches that engage all levels of

an organization in the design of effective, sustainable

workplace interventions

CPH-NEW’s goals include:

(From NIOSH Total Worker Health™ Mission)

www.uml.edu/centers/CPH-NEW

Why a participatory workplace process?

Employee

health self-

efficacy Increased program sustainability

Increased confidence to change

unhealthy conditions

Insights derived

from workers’

perspective

Find (other) root causes of

physical & psychosocial stressors

Find (other) root causes of

unhealthy behaviors

Reflect own experiences, needs

and language of the intended

program participants

Increased decision latitude

Increased social support

www.uml.edu/centers/CPH-NEW www.uml.edu/cphnewtoolkit

Dual committee program structure

• Engages employees in setting priorities and developing solutions

• Improves organizational communication and collaboration

IDEAS intervention planning process • Integrates ergonomics with health promotion initiatives

• Develops a contextual business case for health and safety

interventions, one intervention at a time

• Establishes a sustainable process for continuous health/safety

improvement

CPH-NEW Healthy Workplace

toolkit promotes a healthy organization:

www.uml.edu/centers/CPH-NEW

Design Team

Steering Committee

Recommended participatory program structure

Roles of Steering Committee (SC) & Design Team (DT)

Action &

feedback

Action &

feedback

• Forms DT & provides necessary resources

• Invites DT to develop and propose interventions

• Selects most feasible/desirable interventions

• Develops or extends interventions to middle

management & staff (with help from DT)

• Helps promote & evaluate all interventions

• Identifies & prioritizes employee health issues

• Comes up with ideas for workplace interventions

• Proposes best intervention ideas to SC

• Helps promote & evaluate all interventions

• Helps refine interventions, as needed

www.uml.edu/centers/CPH-NEW

Step 1

Identify Problems & Contributing

Factors

Step 2

Develop

Objectives & Activities

Step 3

Set Selection Criteria

Step 4

Apply Selection Criteria

Step 5a/5b

Rate/Select Intervention Alternatives

Step 6

Plan and Implement

Interventions

Step 7

Monitor & Evaluate

Intervention

How Does the IDEAS Tool Work?

Designing

interventions

with IDEAS

is an

iterative

process

Intervention, Design, and Analysis Scorecard

www.uml.edu/centers/CPH-NEW www.uml.edu/cphnewtoolkit

How to Use the Website

Program start up guides and tutorials • Readiness and resource self-assessment

• Committee formation

• Assessment and problem identification

• Intervention planning

• Develop and evaluate solutions/interventions

IDEAS intervention planning tool for integrated

health protection/health promotion

www.uml.edu/centers/CPH-NEW

CPH-NEW Healthy Worksite

Participatory Program Website

www.uml.edu/centers/CPH-NEW

Interactive Tools

Worksheets and

Quick Reference

Guides for Facilitators

Online Readiness

Survey

www.uml.edu/centers/CPH-NEW

www.uml.edu/centers/CPH-NEW

A CPH-NEW Research-to-Practice (R2P)

Toolkit to promote Total Worker HealthTM

Toolkit was field tested 2010-2012

4 New England employer organizations

Evaluated ease of use, satisfaction, effectiveness

Toolkit addresses 3 shortcomings of conventional

workplace HP programs:

– Little sense of employee ownership, participation

– Little attention to conditions of job demands

– Activities can be event driven, lack sustainability

www.uml.edu/centers/CPH-NEW

www.uml.edu/centers/CPH-NEW

SUCCESSS STORY

Examples of interventions designed at one field

test site….

Resident education materials for move-ins

New uniforms to address overheating

Work order process and policy changes

New hiring addressed staffing issue

Email for all maintenance technicians

Note: Study site continued the program after the end of the study.

www.uml.edu/centers/CPH-NEW

Raised awareness – Employee health, wellness, and safety

Improved communication – Between workers and supervisors

New ideas for interventions – Made change happen, solution-driven

“If this group was not around, our ideas would not be heard as much and less would be accomplished.” --DT member at study site

Impacts to Organization

www.uml.edu/centers/CPH-NEW

Design Team

– New skills- problem solving, communication

– Feelings of value, pride, and respect

– Team building, meeting other co-workers

“He looked forward to the meetings and felt empowered to go and have a say in things.”

-- Manager at study site

Personal Impacts

www.uml.edu/centers/CPH-NEW

Structured process

Uncovers root causes

Leads to more complete solutions

Engages/empowers employees

Builds self-efficacy

Main Reasons for Using the

IDEAS Tool

Resources for workplace health

promotion professionals:

The SafeWell Guidelines

Glorian Sorensen (PI)

Jack Dennerlein, (Co-PI)

Deborah McLellan, (SafeWell PI)

22 August 2014

www.centerforworkhealth.sph.harvard.edu

PI: Glorian Sorensen Co PI Jack Dennerlein

Manager: Lorraine Wallace

Be Well, Work Well

Integrated approaches for

health care workers

2007-

All the Right Moves

Integrated approaches for construction workers

2011-

SafeWell Disseminating integrated

programs to small, medium businesses

2011 -

56

www.centerforworkhealth.sph.harvard.edu

SafeWell Practice Guidelines

57

• SafeWell Practice Guidelines: An Integrated Approach to Worker Health • Purpose: To provide a real-world model of evidence-

based guidelines and tools for TWH programs

• Built on 20 years of research and informed by those who practice integrated approaches.

available at: http://centerforworkhealth.sph.harvard.edu

www.centerforworkhealth.sph.harvard.edu

What’s in the Guidelines?

• Chapter 1: Providing the foundation: Organizational

leadership and commitment and employee

participation

• Chapter 2: Program planning

• Chapter 3: Implementation

• Chapter 4: Evaluation and continual improvement

58

www.centerforworkhealth.sph.harvard.edu

Chapter 1:

Providing the foundation

59

• Culture of Health

• Eliminate work hazards (physical

and psychosocial)

• Worker health and safety is

business success

• Multiple levels of management

• Top management has to

demonstrate commitment

• Mid-levels are on the front line

www.centerforworkhealth.sph.harvard.edu

Systems approach to worker

health and safety

McLellan D et al, 2012

60

www.centerforworkhealth.sph.harvard.edu

Making the Business Case:

Talking points

• Integrated approaches have

been shown to:

• Improve health behaviors1,2

• Improve employee participation

in programs3

• Reduce occupational injury

rates4

• Improve working conditions5

• Improve health and safety

programs5

1. Sorensen, Cancer Causes Ctrl 2002; 2. Sorensen, AJPH 2005; 3. Hunt, Hlth Educ Beh 2005; 4. Maniscalco, JOEM 1999; 5. LaMontagne, OEM 2004; 6. Pronk, JOEM , 2013; 61

www.centerforworkhealth.sph.harvard.edu

Chapter 2: Program planning

Appoint a program planning

team

• Assess organizational

resources and needs

• Health and Safety

Assessment

• Communicate

• Strategic plan using

integrated approaches

• Communicate

62

www.centerforworkhealth.sph.harvard.edu

Chapter 3: Implementation

• Involves conducting activities of the

program plan

• For the SafeWell approach,

implement

• On physical environmental,

organizational, individual levels;

• And link health promotion, safety

and health, and employee

benefits and supports

• Examples:

http://www.cdc.gov/niosh/twh

63

www.centerforworkhealth.sph.harvard.edu

Implementation example –

WellWorks II

• Selected outcomes

• Reducing hazardous

respiratory exposures

• Reducing smoking rates

• Carbon monoxide (CO)

analysis activity1

• Identify high CO levels

• Provides feedback for

smokers

• Flags exposure to CO at

worksites

1 Available in SafeWell Guidelines, Chapter 3, Appendix 1, Page 141

64

www.centerforworkhealth.sph.harvard.edu

Chapter 4: Evaluation

and Continuous Improvement

65

Evaluate for..

• Accountability

• Decision-making

• Improvement

• Surveillance

• longitudinal analysis

• knowledge discovery

Approaches

• A team across departments

• Integrated data management

• Costs, benefits, ROI

• Milestones

• Communicate

www.centerforworkhealth.sph.harvard.edu

Specific resources

66

• Appendix 1.1: Soliciting Employee Advisory Board (EAB) members and EAB job

description (examples from the WellWorks-2 Project)

• Appendix 2.1: Selecting vendors: Topics and questions

• Appendix 2.2: Example of a baseline occupational safety and health audit

• Appendix 2.3: SIMS Checklist

• Appendix 2.4: Example of an injury/exposure investigation form

• Appendix 2.5: JourneyWell Dimensions of Corporate Wellness Scorecard

• Appendix 2.6: Examples of questions for individual worker interviews to

understand their experience specifically on worksite hazards and risks.

• Appendix 2.7: Example of an Assessment Report Outline

• Appendix 3.1: Sample SafeWell programs

• Appendix 3.2: Workplace health promotion and health protection tools and

resources

www.centerforworkhealth.sph.harvard.edu

Acknowledgements and links

• Developed in partnership with

• Dartmouth-Hitchcock Health Care (Robert McLellan)

• HealthPartners (Nico Pronk)

• Partners Health Care (Dean Hashimoto)

• Funded by NIOSH Total Worker HealthTM

U19OH008861

• Distributed by NIOSH at

• http://www.cdc.gov/niosh/twh/

• http://centerforworkhealth.sph.harvard.edu/resources/

safewell-resources

67

Oregon Healthy Workforce Center

• Oregon Health and Science University

– Oregon Institute of Occupational Health Sciences

– Division of Health Promotion and Sports Medicine

• Portland State University, Occupational Health Psychology Program

• Labor Education and Research Center, University of Oregon

• Kaiser Center for Health Research

Dede Montgomery montgomd@ohsu.edu

OHWC Research

• Employs randomized control trial design

• Team-based & technology-based

• Work populations:

– Homecare

– Construction

– Corrections

– Young Workers

http://www.ohsu.edu/ohwc/projects/

http://www.croetweb.com