Last data update: Sep 23, 2024. (Total: 47723 publications since 2009)
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Query Trace: Cunningham TR [original query] |
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An urgent call to address work-related psychosocial hazards and improve worker well-being
Schulte PA , Sauter SL , Pandalai SP , Tiesman HM , Chosewood LC , Cunningham TR , Wurzelbacher SJ , Pana-Cryan R , Swanson NG , Chang CC , Nigam JAS , Reissman DB , Ray TK , Howard J . Am J Ind Med 2024 Work-related psychosocial hazards are on the verge of surpassing many other occupational hazards in their contribution to ill-health, injury, disability, direct and indirect costs, and impact on business and national productivity. The risks associated with exposure to psychosocial hazards at work are compounded by the increasing background prevalence of mental health disorders in the working-age population. The extensive and cumulative impacts of these exposures represent an alarming public health problem that merits immediate, increased attention. In this paper, we review the linkage between work-related psychosocial hazards and adverse effects, their economic burden, and interventions to prevent and control these hazards. We identify six crucial societal actions: (1) increase awareness of this critical issue through a comprehensive public campaign; (2) increase etiologic, intervention, and implementation research; (3) initiate or augment surveillance efforts; (4) increase translation of research findings into guidance for employers and workers; (5) increase the number and diversity of professionals skilled in preventing and addressing psychosocial hazards; and (6) develop a national regulatory or consensus standard to prevent and control work-related psychosocial hazards. |
Health worker mental health: Addressing the current crisis and building a sustainable future
Cunningham TR , Chosewood LC , Davis JG , Rochel de Camargo K . Am J Public Health 2024 114 132-133 |
Vital signs: Health worker-perceived working conditions and symptoms of poor mental health - quality of worklife survey, United States, 2018-2022
Nigam JAS , Barker RM , Cunningham TR , Swanson NG , Chosewood LC . MMWR Morb Mortal Wkly Rep 2023 72 (44) 1197-1205 INTRODUCTION: Health workers faced overwhelming demands and experienced crisis levels of burnout before the COVID-19 pandemic; the pandemic presented unique challenges that further impaired their mental health. METHODS: Data from the General Social Survey Quality of Worklife Module were analyzed to compare self-reported mental health symptoms among U.S. adult workers from 2018 (1,443 respondents, including 226 health workers) and 2022 (1,952, including 325 health workers). Logistic regression was used to examine associations between health workers' reported perceptions of working conditions and anxiety, depression, and burnout. RESULTS: From 2018 to 2022, health workers reported an increase of 1.2 days of poor mental health during the previous 30 days (from 3.3 days to 4.5 days); the percentage who reported feeling burnout very often (11.6% to 19.0%) increased. In 2022, health workers experienced a decrease in odds of burnout if they trusted management (odds ratio [OR] = 0.40), had supervisor help (OR = 0.26), had enough time to complete work (OR = 0.33), and felt that their workplace supported productivity (OR = 0.38), compared with those who did not. Harassment at work was associated with increased odds of anxiety (OR = 5.01), depression (OR = 3.38), and burnout (OR = 5.83). CONCLUSIONS AND IMPLICATIONS FOR PUBLIC HEALTH PRACTICE: Health workers continued to face a mental health crisis in 2022. Positive working conditions were associated with less burnout and better mental health. CDC's National Institute for Occupational Safety and Health has developed a national campaign, Impact Wellbeing, to provide employers of health workers with resources to improve the mental health of these workers. |
A staffing perspective on barriers to and facilitators of temporary worker safety and health
Menger-Ogle LM , Baker D , Guerin RJ , Cunningham TR . Am J Ind Med 2023 66 (9) 736-749 BACKGROUND: Research has documented occupational health disparities, including higher rates of work-related injuries, among temporary workers compared with workers in standard employment arrangements. According to guidance from the Occupational Safety and Health Administration (OSHA) and the National Institute for Occupational Safety and Health (NIOSH), both staffing companies and host employers are responsible for protecting the occupational safety and health (OSH) of temporary workers. To date, there has been little qualitative research on temporary worker OSH in the United States and a lack of evidence-based OSH programs designed to meet the needs of temporary workers. The aim of this study was to better understand the barriers to and facilitators of temporary worker OSH from the perspective of US staffing companies. METHODS: In-depth interviews were conducted with a convenience sample of representatives from 15 US staffing companies. Interviews were audio recorded, transcribed verbatim, and analyzed through a three-step process. RESULTS: Commonly mentioned barriers to temporary worker OSH include differential treatment of temporary workers by host employers; lack of understanding among host employers and staffing companies of joint OSH responsibilities; and workers' fear of job loss or other negative repercussions if they report an injury or illness or voice OSH concerns. Commonly mentioned facilitators of temporary worker OSH include conducting client assessments and site visits and fostering strong communication and relationships with both host employers and temporary workers. CONCLUSIONS: These findings can help inform the tailoring of OSH programs to promote health equity in temporary workers. |
Flynn et al. Respond
Flynn MA , Cunningham TR , Ahonen EQ , Fujishiro K . Am J Public Health 2018 108 (9) e3-e4 We would like to thank Wegman and Davis for their response to our article and congratulate them and their colleagues on the recent report from the National Academies of Science, Engineering, and Medicine: A Smarter National Surveillance System for Occupational Safety and Health in the 21st Century (NAS report).1 We share Wegman and Davis’s optimism that this moment offers an opportunity for developing systems that generate better, more comprehensive data to improve our understanding of the social determinants that drive health inequities and empower society to eliminate health inequities. Whether arguing for a greater recognition for the influence of work on population health or a greater accounting for the role social structures play in health inequalities manifest in the workplace, the need for a more inclusive, social determinant approach to health inequity2 is a central theme of both documents. |
Total Worker Health® and organizational behavior management: Emerging opportunities for improving worker well-being
Olson R , Cunningham TR , Nigam JAS , Anger WK , Rameshbabu A , Donovan C . J Organ Behav Manage 2022 43 (4) 1-40 We draw artificial boundaries between our lives at work, at home, and in the community. Each person is living an integrated life where all of their environments (resources, physical environment, psychosocial environment, responsibilities/demands) interact to impact their safety, health, and well-being. Total Worker Health® is an approach developed by the National Institute for Occupational Safety and Health (NIOSH) to address such interactions, and to advance science and practice for protecting workers’ safety, health, and well-being. The Total Worker Health (TWH) approach represents an expansion of traditional occupational safety and health research and practice, with strong safety protections for workers as its foundation. The current paper provides an introduction to TWH, including: (1) Significance, (2) Historical Background, (3) Hierarchy of Controls, (4) Review of TWH Interventions, and (5) Future Opportunities. The reciprocal and interactive perspective of TWH is consistent with Skinnerian and other approaches to behavioral science, as well as organizational systems analysis approaches. With its behavioral and systems analysis roots, and associated historical emphasis on environmental conditions and interventions, the Organizational Behavior Management community can make great and important contributions in the TWH domain. © 2022 The Author(s). Published with license by Taylor & Francis Group, LLC. |
Applying translational science approaches to protect workers exposed to nanomaterials
Schulte PA , Guerin RJ , Cunningham TR , Hodson L , Murashov V , Rabin BA . Front Public Health 2022 10 816578 Like nanotechnology, translational science is a relatively new and transdisciplinary field. Translational science in occupational safety and health (OSH) focuses on the process of taking scientific knowledge for the protection of workers from the lab to the field (i.e., the worksite/workplace) and back again. Translational science has been conceptualized as having multiple phases of research along a continuum, beyond scientific discovery (T(0)), to efficacy (T(1)), to effectiveness (T(2)), to dissemination and implementation (D&I) (T(3)), to outcomes and effectiveness research in populations (T(4)). The translational research process applied to occupational exposure to nanomaterials might involve similar phases. This builds on basic and efficacy research (T(0) and T(1)) in the areas of toxicology, epidemiology, industrial hygiene, medicine and engineering. In T(2), research and evidence syntheses and guidance and recommendations to protect workers may be developed and assessed for effectiveness. In T(3), emphasis is needed on D&I research to explore the multilevel barriers and facilitators to nanotechnology risk control information/research adoption, use, and sustainment in workplaces. D&I research for nanomaterial exposures should focus on assessing sources of information and evidence to be disseminated /implemented in complex and dynamic workplaces, how policy-makers and employers use this information in diverse contexts to protect workers, how stakeholders inform these critical processes, and what barriers impede and facilitate multilevel decision-making for the protection of nanotechnology workers. The T(4) phase focuses on how effective efforts to prevent occupational exposure to nanomaterials along the research continuum contribute to large-scale impact in terms of worker safety, health and wellbeing (T(4)). Stakeholder input and engagement is critical to all stages of the translational research process. This paper will provide: (1) an illustration of the translational research continuum for occupational exposure to nanomaterials; and (2) a discussion of opportunities for applying D&I science to increase the effectiveness, uptake, integration, sustainability, and impact of interventions to protect the health and wellbeing of workers in the nanotechnology field. |
Work-related fatigue: A hazard for workers experiencing disproportionate occupational risks
Cunningham TR , Guerin RJ , Ferguson J , Cavallari J . Am J Ind Med 2022 65 (11) 913-925 BACKGROUND: Long working hours and fatigue are significant occupational safety and health (OSH) hazards for working populations who experience disproportionate risks of injury and illness. These groups include young or new workers, aging workers, contingent and temporary workers, immigrant and nonnative workers, female workers, minority workers, workers with low levels of education and lower socioeconomic status, and small business employees. An increasing focus on newer determinants of health in the workplace, such as health equity and work-life conflict, in worker populations at greater risk for injury or illness, provides an opportunity for researchers to address the causes and consequences of work-related fatigue in high-risk populations. METHODS: Articles in the OSH literature that addressed fatigue in higher-risk workers were identified by the authors or recommended by subject matter experts in workplace fatigue as part of a Working Hours, Sleep and Fatigue Forum. Additional articles were identified by searching for a combination of specific at-risk worker group titles (e.g., female workers, temporary workers) with fatigue or working hours. RESULTS: There remains a paucity of research specifically addressing working hours and fatigue among disproportionately at-risk worker populations. The literature reviewed in this paper suggests that several of these populations are at increased risk of fatigue due to multiple factors, such as irregular shifts, lack of access to fatigue management resources, and socioeconomic barriers. CONCLUSIONS: More research is needed to identify solutions to address fatigue in working populations who may be at greater risk for its consequences by virtue of adverse socioeconomic and related factors. Interventions to address work-related fatigue in specific at-risk worker groups should also consider the multiple and overlapping categories of risk within these populations. |
Dissemination and implementation science approaches for occupational safety and health research: Implications for advancing total worker health
Guerin RJ , Harden SM , Rabin BA , Rohlman DS , Cunningham TR , Tepoel MR , Parish M , Glasgow RE . Int J Environ Res Public Health 2021 18 (21) Total Worker Health® (TWH), an initiative of the U.S. National Institute for Occupational Safety and Health, is defined as policies, programs, and practices that integrate protection from work-related health and safety hazards by promoting efforts that advance worker well-being. Interventions that apply the TWH paradigm improve workplace health more rapidly than wellness programs alone. Evidence of the barriers and facilitators to the adoption, implementation, and long-term maintenance of TWH programs is limited. Dissemination and implementation (D&I) science, the study of methods and strategies for bridging the gap between public health research and practice, can help address these system-, setting-, and worker-level factors to increase the uptake, impact, and sustainment of TWH activities. The purpose of this paper is to draw upon a synthesis of existing D&I science literature to provide TWH researchers and practitioners with: (1) an overview of D&I science; (2) a plain language explanation of key concepts in D&I science; (3) a case study example of moving a TWH intervention down the research-to-practice pipeline; and (4) a discussion of future opportunities for conducting D&I science in complex and dynamic workplace settings to increase worker safety, health, and well-being. © 2021 by the authors. Licensee MDPI, Basel, Switzerland. |
Translation research in occupational health and safety settings: Common ground and future directions
Cunningham TR , Tinc PJ , Guerin RJ , Schulte PA . J Safety Res 2020 74 161-167 Translation research is a growing field within occupational safety and health. | | • | Several of the frameworks relevant to Translation Research overlap to varying degrees. | | • | Dissemination and implementation science should be embedded into OSH research. | | • | Translation research should not be misunderstood as an add-on activity. |
Evaluation of toolbox safety training in construction: The impact of narratives
Eggerth DE , Keller BM , Cunningham TR , Flynn MA . Am J Ind Med 2018 61 (12) 997-1004 BACKGROUND: Construction is a dangerous industry with a large number of small businesses. Because they require minimal resources to deliver, toolbox talks may be an ideal training format for small construction contractors. METHODS: Eight toolbox talks were developed, each with two versions. One version of each toolbox talk was standard and one version included a narrative and discussion questions. Participants were randomly assigned to receive the standard or the narrative version. Pre- and post-intervention surveys measured demographics, workplace safety climate, and knowledge. The post-intervention survey also measured training impact. RESULTS: Including narratives with discussion questions significantly increased knowledge gain and led to increased training impact. Less experienced workers were more likely to gain knowledge and training impact compared to more experienced workers. There were no significant changes in workplace safety climate. CONCLUSIONS: The results suggest that including a narrative and discussion questions increases toolbox talk effectiveness. |
Components of an occupational safety and health communication research strategy for small- and medium-sized enterprises
Schulte PA , Cunningham TR , Guerin RJ , Hennigan B , Jacklitsch B . Ann Work Expo Health 2018 62 S12-s24 The majority of the global labor force works in firms with fewer than 50 employees; firms with fewer than 250 employees make up 99% of workplaces. Even so, the lack of extensive or comprehensive research has failed to focus on occupational safety and health communication to these small- and medium-sized enterprises (SMEs). Given that the magnitude of all occupational safety and health (OSH) morbidity, mortality, and injury disproportionately occurs in businesses with fewer than 250 employees, efforts to communicate with employers to engage in preventative occupational safety and health efforts merit attention. This article provides an overview of important components that should be considered in developing an occupational safety and health (OSH) communication research strategy targeting SMEs. Such a strategy should raise awareness about the diversity and complexity of SMEs and the challenges of targeting OSH communication toward this diverse group. Companies of differing sizes (e.g. 5, 50, 500 employees) likely require differing communication approaches. Communication strategies will benefit from deconstructing the term 'small business' into smaller, more homogenous categories that might require approaches. Theory-based research assessing barriers, message content, channels, reach, reception, motivation, and intention to act serve as the foundation for developing a comprehensive research framework. Attention to this type of research by investigators is warranted and should be encouraged and supported. There would also be value in developing national and international strategies for research on communication with small businesses. |
Conference summary Understanding Small Enterprises Conference, 25-27 October 2017
Brown CE , Cunningham TR , Newman LS , Schulte PA . Ann Work Expo Health 2018 62 S1-s11 Objectives: The specific objectives of the 2017 Understanding Small Enterprises Conference were to: (i) identify successful strategies for overcoming occupational safety and health (OS&H) barriers in small and medium-sized enterprises (SMEs); (ii) disseminate best practices to research and business communities; (iii) build collaborations between different stakeholders including researchers, insurers, small enterprises, government agencies; and (iv) better inform OS&H research relevant to SMEs. Methods: A two and a half day international conference was organized, building upon three previously successful iterations. This conference brought together researchers, practitioners, and other stakeholders from 16 countries to share best practices and emerging strategies for improving OS&H in SMEs. Findings: Cross-cutting themes that emerged at the conference centered around: 1) stakeholder and intermediary involvement; 2) what occupational health and safety looks like across different industries; 3) intervention programs (tools and resources); 4) precarious and vulnerable work and the informal sector; and 5) Total Worker Health(R) in SMEs. Conclusion: A number of innovative initiatives were shared at the conference. Researchers must build collaborations involving a variety of stakeholder groups to ensure that OS&H solutions are successful in SMEs. Future OS&H research should continue to build upon the successful work of the 2017 Understanding Small Enterprises Conference. |
Safety talk and safety culture: Discursive repertoires as indicators of workplace safety and health practice and readiness to change
Cunningham TR , Jacobson CJ . Ann Work Expo Health 2018 62 S55-s64 Background: Small construction businesses (SCBs) account for a disproportionate share of occupational injuries, days lost, and fatalities in the US and other modern economies. Owner/managers of SCBs confront risks associated with their own and workers' safety and business survival, and their occupational safety and health (OSH) related values and practices are key drivers of safety and business outcomes. Given owner/mangers are the key to understanding and affecting change in smaller firms, as well as the pressing need for improved OSH in small firms particularly in construction, there is a critical need to better understand SCB owners' readiness to improve or adopt enhanced OSH activities in their business. Unfortunately, the social expectation to support safety can complicate efforts to evaluate owners' readiness. Objectives: To get a more accurate understanding of the OSH values and practices of SCBs and the factors shaping SCB owners' readiness and intent to implement or improve safety and health programming by comparing their discourse on safety with their self-rated level of stage of change. Methods: In-depth, semi-structured interviews were conducted with 30 SCB owner managers. Respondents were asked to self-rate their safety program activity on a 5-point scale from unaware or ignorant ('haven't thought about it at all') to actively vigilant ('well-functioning safety and health program for at least 6 months'). They were also asked to discuss the role and meaning of OSH within their trade and company, as well as attitudes and inclinations toward improving or enhancing business safety practices. Analysis and results: Respondents' self-rating of safety program activity was compared and contrasted with results from discourse analysis of their safety talk, or verbal descriptions of their safety values and activities. Borrowing from normative and stage theories of safety culture and behavioral change, these sometimes contradictory descriptions were taxonomized along a safety culture continuum and a range of safety cultures and stages of readiness for change were found. These included descriptions of strong safety cultures with intentions for improvement as well as descriptions of safety cultures with more reactive and pathological approaches to OSH, with indications of no intentions for improvement. Some owner/managers rated themselves as having an effective OSH program in place, yet described a dearth of OSH activity and/or value for OSH in their business. Conclusion: Assessing readiness to change is key to improving OSH performance, and more work is needed to effectively assess SCB OSH readiness and thus enable greater adoption of best practices. |
Differences in safety training among smaller and larger construction firms with non-native workers: Evidence of overlapping vulnerabilities
Cunningham TR , Guerin RJ , Keller BM , Flynn MA , Salgado C , Hudson D . Saf Sci 2018 103 62-69 Collaborative efforts between the National Institute for Occupational Safety and Health (NIOSH) and the American Society of Safety Engineers (ASSE) led to a report focusing on overlapping occupational vulnerabilities, specifically small construction businesses employing young, non-native workers. Following the report, an online survey was conducted by ASSE with construction business representatives focusing on training experiences of non-native workers. Results were grouped by business size (50 or fewer employees or more than 50 employees). Smaller businesses were less likely to employ a supervisor who speaks the same language as immigrant workers (p <.001). Non-native workers in small businesses received fewer hours of both initial safety training (p =.005) and monthly ongoing safety training (p =.042). Immigrant workers in smaller businesses were less likely to receive every type of safety training identified in the survey (including pre-work safety orientation [p <.001], job-specific training [p <.001], OSHA 10-hour training [p =.001], and federal/state required training [p <.001]). The results highlight some of the challenges a vulnerable worker population faces in a small business, and can be used to better focus intervention efforts. Among businesses represented in this sample, there are deficits in the amount, frequency, and format of workplace safety and health training provided to non-native workers in smaller construction businesses compared to those in larger businesses. The types of training conducted for non-native workers in small business were less likely to take into account the language and literacy issues faced by these workers. The findings suggest the need for a targeted approach in providing occupational safety and health training to non-native workers employed by smaller construction businesses. |
Translation research in occupational safety and health: A proposed framework
Schulte PA , Cunningham TR , Nickels L , Felknor S , Guerin R , Blosser F , Chang CC , Check P , Eggerth D , Flynn M , Forrester C , Hard D , Hudson H , Lincoln J , McKernan LT , Pratap P , Stephenson CM , Van Bogaert D , Menger-Ogle L . Am J Ind Med 2017 60 (12) 1011-1022 Translation research in occupational safety and health is the application of scientific investigative approaches to study how the outputs of basic and applied research can be effectively translated into practice and have an impact. This includes the study of the ways in which useful knowledge and interventions are disseminated, adopted, implemented, and institutionalized. In this paper, a 4-stage framework (Development, Testing, Institutionalization, and Evaluation) is presented. Translation research can be used to enhance the use and impact of occupational safety and health knowledge and interventions to protect workers. This type of research has not received much attention in the occupational safety and health field. However, in contemporary society, it is critical to know how to make an impact with the findings and outputs of basic and applied research. This paper provides a novel framework for consideration of how to advance and prioritize translation research for occupational safety and health. |
Considerations for incorporating "well-being" in public policy for workers and workplaces
Schulte PA , Guerin RJ , Schill AL , Bhattacharya A , Cunningham TR , Pandalai SP , Eggerth D , Stephenson CM . Am J Public Health 2015 105 (8) e1-e14 Action to address workforce functioning and productivity requires a broader approach than the traditional scope of occupational safety and health. Focus on "well-being" may be one way to develop a more encompassing objective. Well-being is widely cited in public policy pronouncements, but often as ". . . and well-being" (e.g., health and well-being). It is generally not defined in policy and rarely operationalized for functional use. Many definitions of well-being exist in the occupational realm. Generally, it is a synonym for health and a summative term to describe a flourishing worker who benefits from a safe, supportive workplace, engages in satisfying work, and enjoys a fulfilling work life. We identified issues for considering well-being in public policy related to workers and the workplace. |
A comprehensive approach to identifying intervention targets for patient-safety improvement in a hospital setting
Cunningham TR , Geller ES . J Organ Behav Manage 2012 32 (3) 194-220 Despite differences in approaches to organizational problem solving, healthcare managers and organizational behavior management (OBM) practitioners share a number of practices, and connecting healthcare management with OBM may lead to improvements in patient safety. A broad needs-assessment methodology was applied to identify patient-safety intervention targets in a large rural medical center. This included a content analysis of descriptions of managers' follow-up actions to error reports for nine types of the most frequently occurring errors. Follow-up actions were coded according to the taxonomy of behavioral intervention components developed by Geller et al. (1990). Two error types were identified as targets for intervention, and the outcome of this assessment process indicated a clear need to apply OBM interventions at the management level and thus have a hospital-wide benefit to patient safety. Future implications for using a system-wide approach to identifying and classifying responses to medical error are discussed. |
A safety information campaign to reduce sharps injuries: results from the Stop Sticks campaign
Cunningham TR , Sinclair RC , Harney AMG , Smallwood SW , Christianson AL . J Commun Healthc 2010 3 164-184 Injuries from medical sharps devices and blood-borne pathogen (BBP) exposure are a significant risk to many healthcare workers. Risk awareness communications and sharps safety strategies are key components of BBP exposure prevention efforts. The research reported here includes an evaluation of a large-scale communication intervention aimed at raising awareness among healthcare workers regarding the risks of sharps injuries and BBP exposure, as well as methods of prevention. The Stop Sticks campaign was a multi-media communication intervention targeted at multiple healthcare facilities in Columbia, South Carolina. Following a comprehensive needs assessment in each facility, tailored communications were delivered via several channels. Samples included individual hospital departments, an entire hospital, and a nursing home. Results indicate high levels of knowledge and communication channel recall, minimal attitude and behavior change, and a strong association between sharps-related safety behavior and safety climate. Overall, this research suggests the blitz approach is viable for raising awareness of occupational safety and health issues. Based on these findings, several recommendations are offered for conducting safety campaigns in healthcare facilities. |
Protecting the planet and its people: How do interventions to promote environmental sustainability and occupational safety and health overlap?
Cunningham TR , Galloway-Williams N , Geller ES . J Safety Res 2010 41 (5) 407-16 PROBLEM: The challenges of both occupational safety and health and environmental sustainability require large-scale behavior change for meaningful improvements to occur. Environmental sustainability, or the 'green movement' has received far more attention recently, and certain strategies and recommendations from interventions designed for promoting pro-environmental behaviors may inform efforts to intervene on critical behaviors for improving occupational safety and health. METHOD: A survey of the literature regarding behavioral interventions for both environmental sustainability and occupational safety and health was conducted. Several theoretical approaches are reviewed, and successful approaches from each domain are identified, as well as parallel challenges and points for crossover. Recommendations are provided for adapting environmental sustainability intervention approaches for occupational safety and health applications. IMPACT ON INDUSTRY: Safety and health leaders may achieve sustainable improvements in worker safety and health by harnessing the momentum of the green movement and adapting successful intervention approaches from the environmental sustainability domain. |
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