2. Materials and Methods
2.2. Identifying and Recruiting Intermediaries
2.3. Intermediary Discussions: Initial Perspectives on TWH
2.4. Intermediary Discussions: Formulating the Community-Based Approach
2.5. Intermediaries Engaging with Small Businesses Using TWH
2.6. Focus Group Interview Analysis
3.1. General Reflections on the TWH Concept
3.2. Changes in Intermediaries Based on Experience with TWH Assistance for Small Employers
3.3. What Worked Well and What Didn’t Work Well to Assist Small Businesses with TWH
3.3.1. The Value of Small Employer Groups
3.3.2. Consistency of Engagement of Intermediaries with Small Employers
3.3.3. Flexibility to Meet Employers’ Needs
3.4. Key Challenges to Implementation
3.5. Organizations Best Suited for TWH Assistance for Small Employers
3.5.1. Need to Take Advantage of Existing Networks, Not Create New Ones
3.5.2. Small Versus Large Employers
3.6. Key Drivers to Make TWH Work for Small Businesses
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
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|Community A||Community B|
|Health Department A||Health Department B|
|Healthcare Provider A|
(Hospital Wellness Services)
|Healthcare Provider B|
(Hospital Healthcare/Business Health Services; includes ergonomist)
|Retired Workers Compensation Safety Consultant||Workers Compensation Provider|
|What is your reaction to TWH (as described with the NIOSH definition and examples of TWH interventions )?||Healthcare Provider B stated they thought about TWH in terms of preventive health maintenance and post-injury care.|
Health Departments (A, B) reported limited focus on OSH. Instead, their engagement with employers was mainly focused on workplace health promotion or wellness, with emphasis on physical activity and smoking cessation activities.
|How compatible is the “TWH for small businesses idea” with the past experiences, existing range of program products, and strategic directions of this organization?||Healthcare Provider B stated they felt TWH was fairly compatible because they already had some activities related to wellness and safety, which were similar to the examples of TWH interventions described by the research team (e.g., ergonomics consultations with employers).|
Health Department A felt they did not have any programs currently related to OSH. Instead, their work–life programs tended to focus on wellness.
|How difficult would it be for your organization to try delivering TWH ideas and services to small businesses?||Health Department A noted a barrier for their organzation, specifically, people are unlikely to perform a task not in their job responsibility.|
Healthcare Provider B noted low number of employees per business, and therefore business may not be able to afford services.
|Compared to other business improvement ideas that your organization offers to small businesses, how difficult is the TWH idea to understand for people in your organization?||Healthcare Provider B speculated that some might think of “at work” vs. “outside of work” while others might think of preventive health maintenance versus post-injury care.|
|Would a subsidy make a difference in the willingness of your organization to offer TWH information and/or services to small businesses? If so, how would different subsidy levels make a difference?||The overall opinion was that money makes a difference in most cases:|
Healthcare Provider B felt offering each business some TWH activities about 4 times per year seemed doable for roughly USD 20,000.
In regard to worker safety and health and tax credits or incentives, Health Department A noted that when small businesses have an opportunity to receive a financial reward, the option for financial incentives becomes the benefit most preferred by small businesses employers.
Money was not a factor with the Workers’ Compensation Provider in Community B, because they were simply not interested in wellness. [This group eventually withdrew from participating as a potential intermediary.]
|Community A||Community B|
|Targeted businesses||Located within 4 neighborhoods||Sectors: manufacturing, construction, childcare, municipalities|
|Business Size||5 < eligible < 50 employees|
|Outreach||Phone calls or walking the neighborhood and dropping in to distribute information||Phone calls|
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