OBJECTIVE: Providing health care during the COVID-19 pandemic has been associated with a high mental health burden for health care providers. This study examined patterns of responses and correlates of class membership across commonly assessed mental health symptoms, psychosocial functioning, and moral injury for providers in the United States in Fall 2022. METHOD: A convenience sample of 1,504 primary care physicians, pediatricians, nurse practitioners, and physician assistants who had been in practice for three or more years (M(age) = 46.1 years, SD(age) = 11.3, 58% male) completed self-report measures in an online, opt-in panel survey from September to November 2022. RESULTS: Using latent class analysis, three classes were identified: No/Low Symptoms (64.8%), High Moral Injury (19.9%), and Elevated Symptoms (15.2%). Several factors were correlated with class membership including age, sex, social support, personal risk of COVID-19, pandemic-related work stressors, proportion of COVID-19 patients seen at the height of the pandemic, and death of a patient due to COVID-19. CONCLUSIONS: This study found high levels of mental health symptoms, and problems with psychosocial functioning and moral injury in health care providers well past the pandemic's peak. The results also demonstrated the importance of considering the unique contribution of moral injury to psychosocial functional difficulties experienced by health care providers during the pandemic given their defined role as essential workers. These findings have implications for preventing and managing mental health problems and burnout among providers postpandemic as well as for future pandemics at both the organizational and individual levels. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

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.

COVID-19 workplace mitigation strategies implemented within US businesses have been effective at preventing disease and protecting workers, but the extent of their use is not well understood. We examined reported COVID-19 workplace mitigation strategies by business size, geographic region, and industry using internet panel survey data from US adult respondents working full- or part-time outside the home (fall 2020, N = 1168) andfull- or part-time, inside or outside the home (fall 2021, N = 1778). We used chi-square tests to assess the differences in the strategies used (e.g., masking and COVID-19 screening) and ANOVA tests to examine the group differences on a mitigation strategies summative score. Fewer COVID-19 mitigation strategies were reported by respondents in fall 2021 (compared to fall 2020) across businesses of different sizes and regions. The participants in microbusinesses (1-10 employees) reported significantly (p < 0.05) lower mitigation scores than all other business sizes, and the respondents in these businesses were significantly less likely (p < 0.05) to have paid leave than those in enterprises with >10 employees. The healthcare and education sectors had the highest reported mean score of COVID-19 workplace mitigation strategies. Small and essential businesses are critical to the US economy. Insight is needed on their use of mitigation strategies to protect workers during the current and future pandemics.

We examined parents' COVID-19 vaccination intentions for their children, reasons for not vaccinating, and the potential impact of a school/daycare vaccination requirement or pediatrician's recommendation on vaccination intentions. Two online surveys were conducted in June-July and September-October 2021, before pediatric COVID-19 vaccines were authorized for emergency use in children age < 12 years, with an internet-based, non-probability sample of U.S. adults. Respondents with children (age < 18 years) in the household were asked about their intention (likelihood) of vaccinating these children against COVID-19. Weighted Chi-square tests using a Rao-Scott correction were performed. Vaccinated (45.7 %) versus unvaccinated (6.9 %) parents were almost seven times more likely to have vaccinated their 12-17-year-old children against COVID-19. Approximately 58.4 % of respondents with unvaccinated children ages 2-11 years and 42.4 % of those with children < 2 years said they are "very" or "extremely likely" to vaccinate these children against COVID-19. Female parents were significantly more likely (p < .01 to p < .001) to express lower levels of COVID-19 vaccine intentions. Across all age groups of children unvaccinated against COVID-19, parental vaccine intentions increased with increased household income and education levels. COVID-19 vaccine side effects and safety concerns were primary reasons for not vaccinating children. Strategies including school vaccination requirements and recommendations from pediatricians were shown to increase parental COVID-19 vaccination intentions for some. More research is needed on factors that increase/hinder COVID-19 pediatric vaccine uptake.

OBJECTIVES: We examined COVID-19 vaccination status, intention, and hesitancy and the effects of five strategies to increase the willingness of unvaccinated adults (≥18 years) to get a COVID vaccine. METHODS: Online surveys were conducted between October 1-17, 2020 (N = 14,946), December 4-16, 2020 (N = 15,229), April 8-22, 2021 (N = 14,557), June 17-July 6, 2021 (N = 30,857), and September 3-October 4, 2021 (N = 33,088) with an internet-based, non-probability opt-in sample of U.S. adults matching demographic quotas. Respondents were asked about current COVID-19 vaccination status, intention and hesitancy to get vaccinated, and reasons for vaccine hesitancy. Unvaccinated respondents were assigned to treatment groups to test the effect of five strategies (endorsements, changing social restrictions, financial incentives, vaccine requirements for certain activities, and vaccine requirements for work). Chi-square tests of independence were performed to detect differences in the response distributions. RESULTS: Willingness to be vaccinated (defined as being vaccinated or planning to be) increased over time from 47.6 % in October 2020 to 81.1 % in October 2021. By October 2021, across most demographic groups, over 75 % of survey respondents had been or planned to be vaccinated. In terms of strategies: (1) endorsements had no positive effect, (2) relaxing the need for masks and social distancing increased Intention to Get Vaccinated (IGV) by 6.4 % (p < 0.01), (3) offering financial incentives increased the IGV between 12.3 and 18.9 % (p <.001), (4) vaccine requirements for attending sporting events or traveling increased IGV by 7.8 % and 9.1 %, respectively (p = 0.02), and vaccine requirement for work increased IGV by 35.4 %. The leading causes (not mutually exclusive) for hesitancy were concerns regarding vaccine safety (52.5 %) or side effects (51.6 %), trust in the government's motives (41.0 %), and concerns about vaccine effectiveness (37.6 %). CONCLUSIONS: These findings suggest that multiple strategies may be effective and needed to increase COVID-19 vaccination among hesitant adults during the pandemic.

Objectives. To explore previous COVID-19 diagnosis and COVID-19 vaccination status among US essential worker groups. Methods. We analyzed the US Census Household Pulse Survey (May 26-July 5, 2021), a nationally representative sample of adults aged 18 years and older. We compared currently employed essential workers working outside the home with those working at home using adjusted prevalence ratios. We calculated proportion vaccinated and intention to be vaccinated, stratifying by essential worker and demographic groups for those who worked or volunteered outside the home since January 1, 2021. Results. The proportion of workers with previous COVID-19 diagnosis was highest among first responders (24.9%) working outside the home compared with workers who did not (13.3%). Workers in agriculture, forestry, fishing, and hunting had the lowest vaccination rates (67.5%) compared with all workers (77.8%). Those without health insurance were much less likely to be vaccinated across all worker groups. Conclusions. This study underscores the importance of improving surveillance to monitor COVID-19 and other infectious diseases among workers and identify and implement tailored risk mitigation strategies, including vaccination campaigns, for workplaces. (Am J Public Health. 2022;112(11):1599-1610. https://doi.org/10.2105/AJPH.2022.307010).

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.

Objective: A limited focus on dissemination and implementation (D&I) science has hindered the uptake of evidence-based interventions (EBIs) that reduce workplace morbidity and mortality. D&I science methods can be used in the occupational safety and health (OSH) field to advance the adoption, implementation, and sustainment of EBIs for complex workplaces. These approaches should be responsive to contextual factors, including the needs of partners and beneficiaries (such as employers, employees, and intermediaries). Method(s): By synthesizing seminal literature and texts and leveraging our collective knowledge as D&I science and/or OSH researchers, we developed a D&I science primer for OSH. First, we provide an overview of common D&I terminology and concepts. Second, we describe several key and evolving issues in D&I science: balancing adaptation with intervention fidelity and specifying implementation outcomes and strategies. Next, we review D&I theories, models, and frameworks and offer examples for applying these to OSH research. We also discuss widely used D&I research designs, methods, and measures. Finally, we discuss future directions for D&I science application to OSH and provide resources for further exploration. Result(s): We compiled a D&I science primer for OSH appropriate for practitioners and evaluators, especially those newer to the field. Conclusion(s): This article fills a gap in the OSH research by providing an overview of D&I science to enhance understanding of key concepts, issues, models, designs, methods and measures for the translation into practice of effective OSH interventions to advance the safety, health and well-being of workers. Copyright © 2022

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.

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.

Recent studies indicate an increase in the percentage of adults who reported clinically relevant symptoms of anxiety and depression during the COVID-19 pandemic (1-3). For example, based on U.S. Census Bureau Household Pulse Survey (HPS) data, CDC reported significant increases in symptoms of anxiety and depressive disorders among adults aged ≥18 years during August 19, 2020-February 1, 2021, with the largest increases among adults aged 18-29 years and among those with less than a high school education (1). To assess more recent national trends, as well as state-specific trends, CDC used HPS data (4) to assess trends in reported anxiety and depression among U.S. adults in all 50 states and the District of Columbia (DC) during August 19, 2020-June 7, 2021 (1). Nationally, the average anxiety severity score increased 13% from August 19-31, 2020, to December 9-21, 2020 (average percent change [APC] per survey wave = 1.5%) and then decreased 26.8% from December 9-21, 2020, to May 26-June 7, 2021 (APC = -3.1%). The average depression severity score increased 14.8% from August 19-31, 2020, to December 9-21, 2020 (APC = 1.7%) and then decreased 24.8% from December 9-21, 2020, to May 26-June 7, 2021 (APC = -2.8%). State-specific trends were generally similar to national trends, with both anxiety and depression scores for most states peaking during the December 9-21, 2020, or January 6-18, 2021, survey waves. Across the entire study period, the frequency of anxiety and depression symptoms was positively correlated with the average number of daily COVID-19 cases. Mental health services and resources, including telehealth behavioral services, are critical during the COVID-19 pandemic.

OBJECTIVE: To investigate associations between adverse changes in employment status and physical and mental health among US adults (more than or equal to 18 years) during the COVID-19 pandemic. METHODS: Data from participants (N = 2565) of a national Internet panel (June 2020) were assessed using path analyses to test associations between changes in self-reported employment status and hours worked and physical and mental health outcomes. RESULTS: Respondents who lost a job after March 1, 2020 (vs those who did not) reported more than twice the number of mentally unhealthy days. Women and those lacking social support had significantly worse physical and mental health outcomes. Participants in the lowest, pre-pandemic household income groups reported experiencing worse mental health. CONCLUSIONS: Results demonstrate the importance of providing social and economic support services to US adults experiencing poor mental and physical health during the COVID-19 pandemic.

Young workers in many industrialized countries experience a higher rate of largely preventable occupation-related injuries compared with adults. Safety education and training are considered critical to the prevention of these incidents. This can be promoted by the dissemination and scale-out of an evidence-based, safety training programs in vocational education. The aim of this study was to identify the intervention core components that comprise the "active ingredients" of a safety training intervention for young workers and assess the impact on student outcomes of interest. Fidelity of implementation was operationalized using measures of adherence and quality of intervention delivery. For this study, data were collected through a school-based, cluster randomized trial conducted in 2015 in eight Finnish upper secondary-level vocational schools (n = 229 students in 22 groups, each with one teacher). Results indicate that the intervention core components (safety skills training, safety inoculation training, a positive atmosphere for safety learning, and active learning techniques) had differing associations with student outcomes. Adherence related to the acquisition of safety skills training was the strongest active ingredient in terms of positive effects. Furthermore, quality of delivery in terms of fostering positive learning atmosphere and utilizing active learning methods was associated especially with motivational outcomes. These findings indicate that different active ingredients complemented each other. Contrary to expectations, we found no statistically significant relationship between any of the core components and risk-taking attitudes. The current study advances prevention science by identifying the active ingredients of an evidence-based intervention, implemented in Finnish vocational school settings, that helps protect young workers from work-related morbidity and mortality.

BACKGROUND: Investigating antecedents of behaviors, such as wearing face coverings, is critical for developing strategies to prevent SARS-CoV-2 transmission. PURPOSE: The purpose of this study was to determine associations between theory-based behavioral predictors of intention to wear a face covering and actual wearing of a face covering in public. METHODS: Data from a cross-sectional panel survey of U.S. adults conducted in May and June 2020 (N = 1,004) were used to test a theory-based behavioral path model. We (a) examined predictors of intention to wear a face covering, (b) reported use of cloth face coverings, and (c) reported use of other face masks (e.g., a surgical mask or N95 respirator) in public. RESULTS: We found that being female, perceived importance of others wanting the respondent to wear a face covering, confidence to wear a face covering, and perceived importance of personal face covering use was positively associated with intention to wear a face covering in public. Intention to wear a face covering was positively associated with self-reported wearing of a cloth face covering if other people were observed wearing cloth face coverings in public at least "rarely" (aOR = 1.43), with stronger associations if they reported "sometimes" (aOR = 1.83), "often" (aOR = 2.32), or "always" (aOR = 2.96). For other types of face masks, a positive association between intention and behavior was only present when observing others wearing face masks "often" (aOR = 1.25) or "always" (aOR = 1.48). CONCLUSIONS: Intention to wear face coverings and observing other people wearing them are important behavioral predictors of adherence to the CDC recommendation to wear face coverings in public.

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.

Adolescents and young adults represent approximately 13% of the U.S. workforce (1). Compared with adult workers, young workers (aged 15-24 years) experience higher rates of job-related injury (2,3). To describe injuries among young workers and inform research and prevention activities, CDC's National Institute for Occupational Safety and Health (NIOSH) analyzed national data for 2012-2018 from the occupational supplement to the National Electronic Injury Surveillance System* (NEISS-Work) and for 2018 from the Bureau of Labor Statistics (BLS) Survey of Occupational Injuries and Illnesses (SOII).(†) During the 7-year period, an estimated 3.2 million (95% confidence interval [CI] = 2.6-3.7) nonfatal, job-related injuries to young workers were treated in hospital emergency departments (EDs). From 2012 to 2018, annual rates of work-related injuries(§) treated in the ED (ED-treated injuries) declined overall across all age groups but ranged from 1.2 to 2.3 times higher for workers aged 15-24 years compared with those for adults aged 25-44 years. Workers aged 18-19 years had the highest rate of ED-treated injuries. In 2018, among all age groups, workers in service occupations(¶) had the highest percentage of injuries requiring at least 1 day away from work. Among workers aged 15-17 years, those in the leisure and hospitality industry had the highest percentage of work-related injuries requiring at least 1 day away from work. Occupational injuries can have long-term impacts on health (4). The disproportionate risk of injury among young workers highlights the need for sustained, targeted public health efforts to prepare this population with essential workplace safety and health competencies before they enter the workforce and to provide high-quality safety training and close supervision on the job. NIOSH and its partners developed a free curriculum to teach adolescents workplace safety and health competencies, which includes identification of workplace hazards and methods for addressing them, how to understand their rights and responsibilities as workers, and how to voice concerns about work safety issues (5).

On April 3, 2020, the White House Coronavirus Task Force and CDC announced a new behavioral recommendation to help slow the spread of coronavirus disease 2019 (COVID-19) by encouraging the use of a cloth face covering when out in public (1). Widespread use of cloth face coverings has not been studied among the U.S. population, and therefore, little is known about encouraging the public to adopt this behavior. Immediately following the recommendation, an Internet survey sampled 503 adults during April 7-9 to assess their use of cloth face coverings and the behavioral and sociodemographic factors that might influence adherence to this recommendation. The same survey was administered 1 month later, during May 11-13, to another sample of 502 adults to assess changes in the prevalence estimates of use of cloth face coverings from April to May. Within days of the release of the first national recommendation for use of cloth face coverings, a majority of persons who reported leaving their home in the previous week reported using a cloth face covering (61.9%). Prevalence of use increased to 76.4% 1 month later, primarily associated with increases in use among non-Hispanic white persons (54.3% to 75.1%), persons aged >/=65 years (36.6% to 79.2%), and persons residing in the Midwest (43.7% to 73.8%). High rates were observed in April and by May, increased further among non-Hispanic black persons (74.4% to 82.3%), Hispanic or Latino persons (77.3% to 76.2%), non-Hispanic persons of other race (70.8% to 77.3%), persons aged 18-29 years (70.1% to 74.9%) and 30-39 years (73.9% to 84.4%), and persons residing in the Northeast (76.9% to 87.0%). The use of a cloth face covering was associated with theory-derived constructs that indicate a favorable attitude toward them, intention to use them, ability to use them, social support for using them, and beliefs that they offered protection for self, others, and the community. Research is needed to understand possible barriers to using cloth face coverings and ways to promote their consistent and correct use among those who have yet to adopt this behavior.

Introduction: Even though the majority of youth in the U.S. work, and workers under the age of 18 are seriously injured on the job at higher rates when compared to adults, most adolescents lack instruction on workplace safety and health. Method: This qualitative study examines the extent to which selected U.S. school districts provide workplace safety and health instruction to students and explores the factors that influence districts’ decision to adopt a free, foundational occupational safety and health (OSH) curriculum. Results: Results from key informant interviews conducted with a purposive sample of 34 school administrators revealed that only a third of the districts have at least 75% of their students receive some instruction on workplace safety and health, while 15% indicated they provide no instruction on this topic. District staff who indicated that they provide OSH instruction stated that it is most often taught through career and technical education (CTE; 65%) and/or health classes (26%). They believed the benefits of providing this instruction include assisting students to get jobs (38%) and helping students learn about safety (32%), while competing demands (44%) and time constraints (41%) were identified as barriers to providing OSH education to students. Conclusions: Given the importance of work to teens and their increased risk of work injury, interested stakeholders—including parents, teachers, employers, and the public health community—should promote the inclusion of workplace safety and health instruction in U.S. secondary schools. Practical Applications: This research fills a gap in current knowledge about the extent to which OSH is currently taught within U.S. secondary schools, enumerates barriers and facilitators to the inclusion of workplace safety and health instruction in schools, presents a free, foundational curriculum in workplace safety and health, and provides directions for future research on the vital role schools can play in preparing the future workforce for safe and healthy employment.

Work-related morbidity and mortality are persistent public health problems across all US industrial sectors, including health care. People employed in health care and social services are at high risk for experiencing injuries and illnesses related to their work. Social and behavioral science theories can be useful tools for designing interventions to prevent workplace injuries and illnesses and can provide a roadmap for investigating the multilevel factors that may hinder or promote worker safety and health. Specifically, individual-level behavioral change theories can be useful in evaluating the proximal, person-related antecedents (such as perceived behavioral control) that influence work safety outcomes. This article (1) provides a brief overview of widely used, individual-level behavior change theories and examples of their application to occupational safety and health (OSH)–related interventions that involve the health care community; (2) introduces an integrated theory of behavior change and its application to promoting the OSH of health care workers; and (3) discusses opportunities for application of individual-level behavior change theory to OSH research and practice activities involving health care workers. The use of behavioral science to consider the role of individual behaviors in promoting health and preventing disease and injury provides a necessary complement to structural approaches to protecting workers in the health care industry.

Introduction: For many reasons, including a lack of adequate safety training and education, U.S. adolescents experience a higher rate of job-related injury compared to adult workers. Widely used social-psychological theories in public health research and practice, such as the theory of planned behavior, may provide guidance for developing and evaluating school-based interventions to prepare adolescents for workplace hazards and risks. Method: Using a structural equation modeling approach, the current study explores whether a modified theory of planned behavior model provides insight on 1,748 eighth graders’ occupational safety and health (OSH) attitude, subjective norm, self-efficacy and behavioral intention, before and after receiving instruction on a free, national young worker safety and health curriculum. Reliability estimates for the measures were produced and direct and indirect associations between knowledge and other model constructs assessed. Results: Overall, the findings align with the theory of planned behavior. The structural equation model adequately fit the data; most path coefficients are statistically significant and knowledge has indirect effects on behavioral intention. Confirmatory factor analyses suggest that the knowledge, attitude, self-efficacy, and behavioral intention measures each reflect a unique dimension (reliability estimates ≥0.86), while the subjective norm measure did not perform adequately. Conclusion: The findings presented provide support for using behavioral theory (specifically a modified theory of planned behavior) to investigate adolescents’ knowledge, perceptions, and behavioral intention to engage in safe and healthful activities at work, an understanding of which may contribute to reducing the downstream burden of injury on this vulnerable population—the future workforce. Practical application: Health behavior theories, commonly used in the social and behavioral sciences, have utility and provide guidance for developing and evaluating OSH interventions, including those aimed at preventing injuries and promoting the health and safety of adolescent workers in the U.S., who are injured at higher rates than are adults.

Concerns about the purported “skills gap” (a mismatch between the skills workers have and the skills prospective employers want and need) in the United States are widespread. Young people are at the epicenter of debates about the preparedness of the emerging labor force to compete in a dynamic, global economy and are the focus of national efforts to promote skills-based training, apprenticeships, and jobs.1

BACKGROUND: Workplace safety and health is a major public health concern, but largely absent from the school health curriculum. Little is known about teachers' perceptions of teaching workplace safety and health topics. METHODS: We administered a 41-item questionnaire reflecting the theory of planned behavior, modified to measure knowledge, to 242 middle and high school teachers in career and technical education and academic subjects. We conducted confirmatory factor analysis to assess the measures' psychometric properties and factorial ANOVAs to compare differences among participants' knowledge, attitude toward, self-efficacy, and intention (to teach) workplace safety and health by sex, prior work injury, and main subject taught. RESULTS: Confirmatory factor analyses indicated the measures reflected the theory. Factorial ANOVAs suggested female teachers had statistically significantly lower mean self-efficacy scores than did male teachers to teach workplace safety and health. Male occupational career and technical education teachers demonstrated higher mean knowledge scores than male teachers in other subjects. Participants not injured at work had higher knowledge scores than those who had been injured. CONCLUSION: Self-efficacy (influenced by sex) and knowledge (influenced by subject taught and previous workplace injury) revealed factors that may affect teachers' provision of workplace safety and health education, a critical yet overlooked component of school health.

US adolescents experience a higher rate of largely preventable job-related injuries compared with adults. Safety education is considered critical to the prevention of these incidents. This study evaluates the effectiveness of a foundational curriculum from the National Institute for Occupational Safety and Health (NIOSH), Talking Safety, to change adolescents' workplace safety and health knowledge, attitude, subjective norm, self-efficacy, and behavioral intention to engage in workplace safety actions. The study also examines the impact of teacher fidelity of curriculum implementation on student outcomes. A multilevel evaluation, based on a modified theory of planned behavior, was conducted in 2016 with 1748 eighth-graders in Miami-Dade, Florida. Post-intervention, students had statistically significant increases (p < .05) in mean scores across outcomes: workplace safety knowledge (34%), attitude (5%), subjective norm (7%), self-efficacy (7%), and behavioral intention (7%). Consistent with theory, gains in attitude (b = 0.25, p < .001), subjective norm (b = 0.07, p < .01), and self-efficacy (b = 0.55, p < .001) were associated with gains in behavioral intention. Higher levels of implementation fidelity were associated with significant gains across outcome measures: knowledge (b = 0.60, p < .001), attitude (b = 0.08, p < .01), subjective norm (b = 0.04, p < .001), self-efficacy (b = 0.07, p < .01) and behavioral intention (b = 0.07, p < .01). Findings demonstrate the effectiveness of Talking Safety, delivered with fidelity, at positively changing measured outcomes, and provide support for using this curriculum as an essential component of any school-based, injury prevention program for young workers.

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.

Work, a defining feature of adolescence in the United States, has many benefits. Work also has risks, as adolescents experience a higher rate of serious job-related injuries compared to adults. Talking Safety, a free curriculum from the National Institute for Occupational Safety and Health, is one tool educators may adopt to provide teens with essential workplace safety and health education. Adolescents (N = 2503; female, 50.1%; Hispanic, 50.0%) in a large urban school district received Talking Safety from their eighth-grade science teachers. This study used a modified theory of planned behavior (which included a knowledge construct), to examine students' pre- and post-intervention scores on workplace safety and health knowledge, attitude, self-efficacy, and behavioral intention to enact job safety skills. The results from confirmatory factor analyses indicate three unique dimensions reflecting the theory, with a separate knowledge factor. Reliability estimates are omega >/= .83. The findings from the structural equation models demonstrate that all paths, except pre- to posttest behavioral intention, are statistically significant. Self-efficacy is the largest contributor to the total effect of these associations. As hypothesized, knowledge has indirect effects on behavioral intention. Hispanic students scored lower at posttest on all but the behavioral intention measure, possibly suggesting the need for tailored materials to reach some teens. Overall the findings support the use of a modified theory of planned behavior to evaluate the effectiveness of a foundational workplace safety and health curriculum. This study may inform future efforts to ensure that safe and healthy work becomes integral to the adolescent experience.

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.

BACKGROUND: An online, multiple-choice assessment was developed and validated for Youth@Work-Talking Safety, a NIOSH curriculum that equips middle and high school students with foundational workplace safety and health knowledge and skills. METHODS: Classical Test Theory was used for the test development and validation; the Jaeger method was used for cut score determination. A total of 118 multiple-choice items were developed to measure the acquisition of knowledge and skills taught through the NIOSH curriculum. Pilot testing was conducted with 192 8-12th grade students and a cut score was determined. RESULTS: The mean score for all test-takers on the Talking Safety assessment was 80.9%; total test reliability measured using an Alpha/KR20 statistic was 0.93. A minimum passing (cut) score of 74% was established. CONCLUSIONS: The assessment provides an objective measure of students' acquisition of the foundational workplace safety and health competencies taught through the Talking Safety curriculum. Am. J. Ind. Med.

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.