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Int. J. Environ. Res. Public Health 2018, 15(11), 2354; https://doi.org/10.3390/ijerph15112354

A Cluster Randomized Controlled Trial of a Total Worker Health® Intervention on Commercial Construction Sites

1
Harvard Center for Work, Health and Wellbeing, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
2
Department of Health Sciences, Bouvé College of Health Sciences, Northeastern University, Boston, MA 02115, USA
3
Department of Physical Therapy, Movement and Rehabilitation Science, Bouvé College of Health Sciences, Northeastern University, Boston, MA 02115, USA
*
Author to whom correspondence should be addressed.
Received: 7 October 2018 / Revised: 20 October 2018 / Accepted: 23 October 2018 / Published: 25 October 2018
(This article belongs to the Special Issue Using Total Worker Health to Advance Worker Health and Safety)
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Abstract

This study evaluated the efficacy of an integrated Total Worker Health® program, “All the Right Moves”, designed to target the conditions of work and workers’ health behaviors through an ergonomics program combined with a worksite-based health promotion Health Week intervention. A matched-pair cluster randomized controlled trial was conducted on ten worksites (five intervention (n = 324); five control sites (n = 283)). Worker surveys were collected at all sites pre- and post- exposure at one- and six-months. Linear and logistic regression models evaluated the effect of the intervention on pain and injury, dietary and physical activity behaviors, smoking, ergonomic practices, and work limitations. Worker focus groups and manager interviews supplemented the evaluation. After controlling for matched intervention and control pairs as well as covariates, at one-month following the ergonomics program we observed a significant improvement in ergonomic practices (B = 0.20, p = 0.002), and a reduction in incidences of pain and injury (OR = 0.58, p = 0.012) in the intervention group. At six months, we observed differences in favor of the intervention group for a reduction in physically demanding work (B = −0.25, p = 0.008), increased recreational physical activity (B = 35.2, p = 0.026) and higher consumption of fruits and vegetables (B = 0.87, p = 0.008). Process evaluation revealed barriers to intervention implementation fidelity and uptake, including a fissured multiemployer worksite, the itinerant nature of workers, competing production pressures, management support, and inclement weather. The All the Right Moves program had a positive impact at the individual level on the worksites with the program. For the longer term, the multi-organizational structure in the construction work environment needs to be considered to facilitate more upstream, long-term changes. View Full-Text
Keywords: organizational intervention; health promotion; injury prevention; musculoskeletal; ergonomics; mixed-methods study; construction industry; safety management; health risk behaviors; occupational health organizational intervention; health promotion; injury prevention; musculoskeletal; ergonomics; mixed-methods study; construction industry; safety management; health risk behaviors; occupational health
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Peters, S.E.; Grant, M.P.; Rodgers, J.; Manjourides, J.; Okechukwu, C.A.; Dennerlein, J.T. A Cluster Randomized Controlled Trial of a Total Worker Health® Intervention on Commercial Construction Sites. Int. J. Environ. Res. Public Health 2018, 15, 2354.

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