Effectiveness of Toolbox Talks as a Workplace Safety Intervention in the United States: A Scoping Review

Abstract

Toolbox Talks are widely adopted and valued by supervisors and safety managers as a core component of occupational safety and health training, yet their effectiveness as an intervention has not been systematically evaluated in the peer-reviewed literature. Persistently high rates of occupational fatalities and injuries, particularly among high-risk industries, compounded by an increasingly diverse workforce, involving linguistic diversity, high turnover, and mobile job sites, highlight the urgent need for evidence-based approaches to safety training. This scoping review addresses this gap by examining the effectiveness of Toolbox Talks as an occupational safety intervention through three guiding questions focused on their reported impact, implementation challenges, and the best practices and delivery methods that enhance their effectiveness. The Adult Learning Theory served as the framework to assess evidence-based studies. Four bibliographic databases were used to search for studies published between 2000 and 2024. Data were charted based on effectiveness, measured as outcomes, and categorized as any combination of safety knowledge, attitudes, beliefs, behavior, or health outcomes. Unforeseen challenges and recommended best practices were gleaned from each study to provide additional insight. A total of fourteen (14) studies met our inclusion criteria, with the majority centered on construction workplaces (n = 10). Reported effectiveness outcome measures were positive across all studies, with notable improvements in workers’ safety knowledge. Training challenges encountered included worker disengagement, language diversity, and production pressures. Recommended best practices for increasing Toolbox Talk training effectiveness included conducting regularly scheduled training, engaging workers, training supervisors, and providing culturally appropriate and tailored materials. While Toolbox Talks demonstrate significant potential to enhance workplace safety, their effectiveness is hinged on the quality of content and delivery methods, particularly when aligned with adult learning principles that emphasize relevance, engagement, and experimental learning. Future research should explore how emerging technologies, such as e-learning platforms, combined with cultural inclusive approaches and long-term impact assessments, can optimize the design and implementation of Toolbox Talks across diverse occupational settings.

1. Introduction

Over the past century, advancements in occupational safety and health (OSH) practices in the United States have led to significant reductions in workplace injuries, illnesses, and fatalities [1,2]. Despite this progress, high-risk industries, including construction, transportation, agriculture, and mining sectors, continue to account for nearly half of all occupational fatalities [3,4]. In 2021 alone, transportation incidents accounted for nearly 40% of all workplace fatalities in the United States, and more than 1000 construction workers lost their lives on the job, a trend that mirrors fatality patterns in Canada and Europe [5,6]. These alarming statistics highlight the urgent need for comprehensive OSH training approaches that not only raise worker awareness of job-specific hazards but reinforce safe work practices and foster a robust culture of work safety.

1.1. Toolbox Talks

TBTs are brief, structured safety meetings typically led by supervisors or crew leaders at the beginning of a shift. These talks are designed to reinforce hazard awareness and safe work practices through short, focused discussions lasting 5 to 15 min [7,8] The content often addresses site-specific risks and uses a conversational style to engage workers in practical safety considerations. While generic templates are readily available online and adaptable across various sectors, the informal yet functional design of TBTs makes them particularly useful across diverse work environments including construction, landscaping, manufacturing, tree care, and roofing [9,10].

The precise origin of “Toolbox Talks” (TBTs), or “Tailgate Talks”, as a safety and educational training tool is not well documented in the existing literature. However, empirical evidence suggests that TBTs may have evolved organically in response to evolving workplace needs. The introduction of workers’ compensation and tighter employer liability laws in 1930s likely contributed to their development, particularly among large, high-risk industrial occupations including mining, manufacturing, and heavy construction as a practical way to communicate safety information [7]. In one of the earliest peer-reviewed studies identified from our search, Kines and colleagues (2010) outlined a conceptual design, application, and approach resembling a TBT, though the term itself was not specifically denoted as a TBT [8]. The study design employed pre- and post-intervention that focused on “daily coaching” and structured safety communication between construction supervisors and workers. The findings revealed significant upward increases in safety outcomes among two intervention groups (7% and 12%, respectively) compared to a lack of measurable changes in three control groups [8]. These findings underscore the early foundations of TBTs as an effective communication tool, demonstrating the value of daily, structured safety communication to improve workplace safety [8,9,10,11].

1.2. The Significance of Toolbox Talks

The growing complexity of modern worksites and the increasing diversity of the workforce demand practical, flexible, and timely communication methods tailored to site-specific hazards [7,9,10]. In this context, the construction industry has been a focal point for TBT research, largely due to its dynamic environment and high injury rates [8,9,12,13,14,15]. OSHA regulations (i.e., U.S. Title 29 Code of Federal Regulations (CFR), 29 CFR 1926.21(b)(2), 29 CFR 1910.1200(h), and 29 CFR, 1926.503(a)), mandate that employers provide safety training to help workers recognize hazards, understand chemical safety protocols, and implement fall protection measures. While traditional approaches to OSH training such as structured classroom instruction or formal certifications programs are foundational, they are often ill-suited for field settings that require real-time, context-specific safety communication [16]. TBTs can help fill this gap by offering brief, practical sessions that supplement regulatory requirements while enhancing safety culture and communication.

1.3. Theoretical Framework

This review is conceptually grounded in Knowles’ Adult Learning Theory (andragogy) and the Health Belief Model (HBM). According to Knowles (1980), adults are most receptive to learning when material is relevant, problem-centered, and self-directed [17]. TBTs support these principles by focusing on real-world hazards in a concise, conversational, and participatory format.

In parallel, the HBM suggests that individuals are more likely to adopt preventive behaviors when they perceive themselves as susceptible to harm, believe the consequences are serious, and recognize the benefits of taking proactive action [18]. TBTs put this theory into action by framing risks within the context of everyday tasks, encouraging dialogue, and linking hazard recognition to safety behaviors. Together, these frameworks support the value of TBTs as behavioral interventions grounded in cognitive and motivational theory.

1.4. Objectives

Although TBTs are widely adopted and valued as an OSH training tool, their overall effectiveness as a workplace intervention has not been comprehensively documented in the peer-reviewed literature. Persistently high rates of occupational fatalities and injuries compounded by challenges like workforce turnover, linguistic diversity, transient workforce, and dynamic job sites underscore the need for a systematic, evidence-based evaluation [19].

To address this gap, the purpose of this scoping review is to assess the current state of evidence on TBTs by exploring three guiding research questions:

• What is the reported effectiveness of TBTs as an occupational safety intervention?
• What challenges and barriers are associated with their implementation?
• What best practices and delivery methods enhance their impact?

This review synthesizes key findings on TBTs to inform inclusive communication strategies, guide training policy, and promote workplace safety outcomes. Limiting the scope to U.S.-based studies reduces contextual variation due to differing international regulatory environments, while still offering insights relevant to safety professionals worldwide.

2. Materials and Methods

2.1. PRISMA Scoping Review

A scoping review of the literature was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines [20]. This methodology was selected due to the broad and exploratory nature of the research questions and the heterogeneity of study designs and outcomes related to TBTs.

2.2. Eligibility Criteria

To be included in the scoping review, a study had to meet the following criteria:

(i)

Involve the use of TBTs as a component of OSH training and educational intervention, and/or be used as a major component of the study design;

(ii)

Published in English between the years 2000 and 2024;

(iii)

Focus on work groups or the worker population in the United States;

(iv)

Report either qualitative or quantitative results as an outcome of the educational safety training intervention.

To capture a comprehensive overview of applications, no restrictions were placed on study design or industry type.

2.3. Measures of Effectiveness

The post-intervention outcome(s) from each study were used to determine “effectiveness” in one or more of the competency domains described by Robson et al. (2010) and Burke et al. (2016) [16,21]. These domains include:

• Safety Knowledge (SK): Defined as factual or procedural knowledge gained through training (e.g., understanding emergency procedures or safe equipment use).
• Safety Attitudes and Beliefs (SAB): Defined as psychological or emotional factors such as safety mindset, perceived risks, and self-efficacy.
• Safety Behavior (SB): Observable safety-related actions (e.g., using PPE or completing safety checks).
• Health Outcomes (HO): Measurable health effects or reductions in injury risk or exposure.

2.4. Exclusion Criteria

Studies were excluded if they were published before 1 January 2000 or after 31 December 2024, conducted outside the U.S., included non-workers or other populations (e.g., students or the public), non-workplace environments, or did not involve TBTs as an intervention with measurable outcomes. Studies that lacked clear post-intervention outcomes were also excluded.

2.5. Search Strategy

To identify relevant articles, a systematic search of published and grey literature (i.e., white papers, dissertations, etc.) was conducted in December 2024. Comprehensive searches were performed in four databases: PubMed, Scopus, Google Scholar, and Pro Quest. Key search terms included, “toolbox”, “talks”, “tailgate talks”, and the related terms “intervention” and “workplace safety” (

Table A1. Search Strategy: Databases and Keyword Search Terms.

Database	(“Toolbox Talks” [All Fields]) AND (“Workplace Safety” [MeSH Terms] OR “Safety” [All Fields]) AND “Intervention” [All Fields]	(“Tailgate Talks” [All Fields]) AND (“Workplace Safety” [MeSH Terms] OR “Workplace Safety” [All Fields]) AND “Intervention” [All Fields]
PubMed	106	2
Scopus	149	23
Google Scholar	16	8
ProQuest	45	3

). Searches were conducted to identify relevant articles in the title, abstract, and keywords of articles. Boolean operators (AND, OR) were used to combine search terms, and truncation (e.g., “toolbox”) was applied to capture variations of key terms. Filters were applied to restrict the results to studies published in English and within the specified date range of 1 January 2000 to 31 December 2024.

2.6. Screening and Data Charting

The screening process was carried out independently by two authors (GK, JH). Any disagreements were resolved through discussion or, if needed, consultation with a third reviewer. After removing duplicates, the remaining articles were screened in sequence of title, keywords, abstract, and full text. Data for the eligible studies were charted according to the authors, publication year, study intervention objective(s), study approach, participant sample size, location/setting, effectiveness category (SK, SAB, SB, HO), and key findings. Studies with multiple objectives were included if the TBT was a component of the OSH intervention and outcome assessment.

2.7. Narrative Synthesis

A narrative synthesis was conducted on the charted data to summarize findings according to their effectiveness domain and key themes. Studies were grouped by the type of outcome measured and qualitative insights regarding implementation challenges, barriers, and best practices. Given the exploratory nature of this scoping review, a formal quality appraisal was not conducted.

3. Results

As shown in Figure A1, a total of 352 related articles were identified. After removing duplicates (n = 140 articles), a total of 212 unique titles and abstracts were screened. Based on exclusion criteria, 187 papers were excluded due to lack of relevance, interventional focus, or target population alignment. Full-text screening of the remaining 25 articles yielded 14 studies meeting the inclusion criteria that were included in the final analysis.

3.1. Study Characteristics

Overall, these studies encompassed a wide range of intervention objectives, primarily aimed at improving safety knowledge, attitudes, and behaviors through tailored TBTs (

Table 1. Toolbox Talk Intervention Studies and Effectiveness in the United States (2000–2024).

* Effectiveness		TBT Intervention/Objective	Study Approach	Participants/Setting	Outcomes/Key Findings
SK, SAB	Reed et al., [22]	To evaluate impacts of TBT training on three dimensions of risk perception—knowledge, dread (fear), and control of hazardous chemicals.	Quasi-experimental; 20 min TBT training sessions held over a 4-month period using pre- and post-surveys.	n = 57; bleach processing plant workers (Southern U.S.).	Slight improvement in safety knowledge, significant decrease in dread, no change in control.
SK, SAB	Al-Shabbani [23]	To evaluate effectiveness of new, customized, pre-task TBTs regarding impact on safety knowledge and awareness among highway maintenance workers.	Quasi-experimental, with mixed methods; pre- and post-intervention knowledge assessments and observational recordings.	n = 150 (16 highway maintenance crews) (Kentucky).	Safety knowledge improved by 22%; safer behavior likelihood increased by 33.2% when pre-task TBT was used.
SK, SAB	Eggerth et al. [15]	To evaluate retention of knowledge and workplace safety among small construction companies using standard vs. narrative- and question-based TBTs.	Quasi-randomized; pre- and post-training impact surveys.	n = 351 (at baseline); 9 small construction companies and 16 worksites (Ohio).	Narrative-based and discussion questions increased TBT effectiveness in knowledge retention and training impact, no significant change in safety climate.
SK, SAB	Rovai et al. [24]	To evaluate increased understanding of safe work practices and personal safety following culturally appropriate TBT educational program among Spanish-speaking dairy workers.	Quasi-experimental with observational component over a 10-week study period.	n = 120; Latino dairy workers (California).	Improvements in worker knowledge, awareness of task-specific hazards, and confidence in abilities to perform job. Positive changes reported by employers in workers’ attitudes, practices, and performance [23].
SK, SAB	Olson et al. [14]	To evaluate different components of new TBT featuring new materials including (i) line drawings and structured safety messages; (ii) worker reactions and desirability of new TBT vs. traditional full-length investigation reports.	Quasi-experimental with interactive, participatory approach.	(i) n = 30; construction supervisors/workers. (ii) Eight construction crews (Greater Portland, Oregon).	(i) Enhanced hazard identification accuracy with line drawings over photos and (ii) preference over short, brief TBT materials. Stronger intentions to engage in preventative measures and behavior noted.
SK, SAB	Harrington et al. [25]	To assess the effectiveness (frequency and quality) of a state-wide, multi-faceted, “training-of-trainers” tailgate program among key construction personnel (e.g., supervisors, safety directors, union reps).	Quasi-experimental; mixed methods with formative and process evaluations given at 6 months post-training (3-year study period).	n = 1195; construction workers at multiple sites (California).	Overall, 86% (n = 832) of those trained found TBTs very helpful, with “how to conduct a TBT” being the most useful thing learned. Increased training frequency found for 77% of contractors (n = 84).
SK, SAB, SB	Kaskutas et al. [11]	To assess tailored, site-specific TBTs for (i) increased frequency, delivery, and effectiveness of fall prevention and communication training for residential carpentry foremen; and (ii) integration of ergonomics into standard TBT program among construction trade workers.	Quasi-experimental, longitudinal; participatory training with pre- and post-intervention surveys at 6, 12, and 24 weeks. Likert-type, level-of-agreement survey on TBT topics/content and delivery method.	(i) n = 86 construction foremen; n = 273 control. (ii) n = 36 construction workers (Greater St. Louis area, Missouri).	(i) Increased frequency and improvement in delivery and effectiveness of TBTs. (ii) Increased awareness of work methods; observed changes in workers’ ergonomic safety behavior.
SK, SAB, SB	Kaskutas et al. [9]	To evaluate feasibility and impact of fall prevention and communication training program among construction foremen.	Quasi-experimental, mixed methods; 8 h training.	n = 29 observational audits; n = 97 construction foremen/crewmember surveys (St. Louis, Missouri).	Increased TBT frequency and improved safety communication; safer behaviors and enhanced fall prevention awareness.
SK, SAB, SB	Kaskutas et al. [12]	To assess improvements in safety communication skills and reduce unsafe behaviors among construction crews following intervention.	Quasi-experimental, mixed methods; 8 h training program covering fall prevention, communication strategies, and safety audits.	Residential contractor, n = 17 construction foremen; 2 managers who supervised foremen (Midwest).	Increased use of daily TBTs (from 13% to 68%) observed among foremen. Use of fall protection (PFAS) increased; unsafe behaviors decreased significantly.
SK, SB	Brnich et al. [26]	To assess knowledge and awareness following the use of 5–7 min training videos and TBTs as teaching tools among a group of mining workers.	Quasi-experimental; pre- and post-study questionnaires assessing levels of knowledge and awareness on OSH emergency communication topics.	n = N/S (mining workers) (Colorado).	Significant increases in post-training scores in knowledge and awareness; slight increase in awareness observed among older, more experienced miners.
SK, SB, HO	Caban- Martinez et al. [27]	To evaluate worker knowledge and N95 respirator use among silica workers following the use of interactive educational TBTs.	Quasi-randomized with pre- and post-assessments and focus groups.	n = 248 construction workers across 5 job sites (Florida).	Increased worker baseline knowledge, practice, and health outcomes post-TBT intervention; 65% increase in use of N95 respirator among experimental group vs. 33% in control group.
SB	Rice et al., [28]	To evaluate whether sending safety TBTs about workplace fatalities to construction supervisors by mobile phone would increase their compliance with regulatory standard for conducting at least one safety meeting each month.	Quasi experimental; pre/post-impact surveys.	n = 56; construction supervisors (Oregon).	Compliance increased by 19.39%; no significant change in communication quality or performance.
SB, SAB	Sparer et al. [29]	To evaluate the integration of a safety communication and recognition program using a redesigned TBT among multiple construction trade groups.	Quasi-experimental; over a 2-month period.	n = 30 construction workers at 1 job site (Boston, Massachusetts).	Enhanced safety climate and communication; barriers in subcontractor scoring noted.
SB, SAB, HO	Kaskutas et al. [12]	To evaluate foremen’s ability to train construction crews in designing/delivering TBTs on fall prevention and safety communication when working at heights.	Quasi-experimental; participatory, 8 h fall prevention and communication training; pre- and post-intervention impact surveys and audits.	n = 84 construction foremen; n = 235 crew members pre-intervention, n = 250 post-intervention, and n = 93 at follow-up (Missouri).	Sustained improvement in fall prevention behaviors and safety communication; predicted 16.6% reduction in self-reported falls.

Notes: * Outcome assessment categories include: SK = knowledge; SAB = attitudes and beliefs (including attitudes, beliefs, perceived risk, self-efficacy, behavioral intentions). SB = observable behaviors (including behavior-dependent hazards and exposures). N/S = not specified.

). The study approaches were predominantly quasi-experimental (n = 12) or quasi-randomized designs (n = 2), employing mixed methods and pre- and post-assessments.

Study participants were represented across different occupations, with the majority in construction (n = 11); others included dairy farming (n = 1), highway maintenance (n = 1), and mining (n = 1). Sample size ranged from small groups of foremen and crews (e.g., n = 17–97) to larger, multi-site cohorts (e.g., n = 1195). Settings were varied, including residential and commercial construction sites and processing and manufacturing facilities.

3.2. Narrative Summary of Toolbox Talk Evaluation and Effectiveness

Across the fourteen studies reviewed across four primary outcome domains (

Table 2. Summary of Toolbox Talk Studies Evaluating OSH Training Effectiveness in the United States (n = 14; 2000–2024).

Effectiveness Category	(n)	(%)	References
Safety Knowledge (SK)	11	79%	Reed et al. [22]. Al-Shabbani et al. [30]. Eggerth et al. [15]. Rovai et al. [24]. Olson et al. [13]. Harrington et al. [25]. Kaskutas et al. [9,11,12]. Brnich et al. [26]. Caban-Martinez et al. [27].
Safety Attitudes and Beliefs (SAB)	11	79%	Reed et al. [22]. Al-Shabbani et al. [23] Eggerth et al. [15]. Rovai et al. [24]. Olson et al. [13,24]. Harrington et al. [25]. Kaskutas et al. [9,11,12]. Sparer et al. [29]
Safety Behavior (SB)	8	57%	Brnich et al. [26]. Caban-Martinez et al. [27]. Rice et al. [28]. Sparer et al. [29]. Kaskutas et al. [9,11,12]
Health Outcomes (HO)	2	14%	Kaskutas et al. [11]. Caban-Martinez et al. [27]

. Summary of Toolbox Talk Studies Evaluating OSH Training Effectiveness in the United States (n = 14; 2000–2024)), eleven of the total studies (79%) evaluated SK and SAB (respectively), eight studies (57%) evaluated SB, and two reported HO (14%).

• Safety Knowledge (SK): Following post-TBT interventions, all studies assessing SK reported improvements in workers’ safety knowledge, varying from slight to considerably high. Several studies highlighted increased worker knowledge in the areas of identifying risk hazards and applying safe work practices. These findings affirm TBTs’ ability to enhance factual safety knowledge through brief targeted instruction.
• Safety Attitudes and Beliefs (SAB): Studies assessing SAB demonstrated that improved SK frequently translated into workers’ safety perceptions, attitudes, and beliefs being shaped leading to improved hazard awareness and greater confidence in their ability to perform job tasks safely. This relationship between knowledge and attitudinal changes was emphasized in studies by Rovai et al. [24], Al-Shabbani [30], Eggerth et al. [15], Kaskutas et al. [9,11,12], and Olson et al. [13]. These findings suggest that well-structured TBTs can influence not only what workers know but also how they think about safety.
• Safety Behavior (SB): Behavioral outcomes varied, though most studies noted positive changes in worker practices. For example, Brnich et al. reported modest increases in observable safety awareness among older, more experienced mining workers [26]. Other studies showed stronger behavioral impacts including compliance with regulatory standards [28], increased use of personal protective equipment (PPE) [12,27,29], improved safety communication, adherence to safety behaviors, and better fall prevention practices [9,11,12,13]. Several TBT studies that engaged workers through tailored messages and participatory formats demonstrated effectiveness in shifting daily behaviors and worksite norms. These studies also documented safer work practices and improved actions for protecting health [27,29].
• Health Outcome (HO): Although less frequently assessed, health outcomes were documented in two studies, both of which demonstrated broader organizational benefits, including reductions in workplace exposures and improved protective behaviors. Studies by Caban-Martinez et al. and Kaskutas et al. found that TBTs contributed to safer practices at the team level, reinforcing the value of TBTs in promoting not just individual behavior change but system-level safety culture improvements [12,27].

Together these findings suggest that TBTs can positively influence multiple dimensions of occupational safety, from enhancing individual knowledge and perceptions to shaping organizational norms and practices. However, despite their documented benefits, noted barriers, as outlined below, can hinder consistent implementation and sustained impact. Understanding and addressing these challenges is essential for advancing inclusive, effective, and scalable safety training strategies.

3.3. Challenges Identified

While all studies reviewed reported positive post-intervention outcomes, worker disengagement emerged as a common challenge. Reed and colleagues noted that more-experienced workers tended to be less engaged and perceived TBTs as redundant or unnecessary [22] (

Table A2. Challenges, Barriers, and Best Practices Reported in Toolbox Talk Studies, United States (2000–2024).

Reference	Challenges or Barriers Identified	Best Practices Identified	Study Context
Reed et al. [22]	Limited engagement among experienced workers due to perceived redundancy of safety information.	Tailor safety messages to worker experience levels to address skepticism.	Chemical processing
Rice et al. [28]	Reduced interaction and engagement in text-message-based TBTs compared to in-person formats.	Supplement text message TBTs with periodic in-person discussions to improve engagement.	Construction (residential)
Rovai et al. (2020)[24]	Production pressures limited time for comprehensive TBT delivery.	Schedule TBTs at the start of shifts to integrate safety messages seamlessly with workflows.	Dairy farming
Al-Shabbani[30]	High worker turnover disrupted continuity in pre-task TBT exposure.	Use pre-task TBTs that are task-specific and delivered daily to reinforce learning.	Highway maintenance, Kentucky
Eggerth et al.[15]	Inconsistent participation among transient construction workers.	Integrate narratives into TBTs to make safety messages relatable and engaging.	Construction (residential)
Caban-Martinez et al. [27]	Language barriers and cultural differences hindered PPE training engagement.	Develop culturally tailored, multilingual TBT materials to engage diverse workforces.	Construction
Kaskutas et al.[11]	High crew turnover reduced continuity of fall prevention messaging across worksites.	Develop sustained TBT programs with small-group discussions and follow-ups.	Construction (residential)
Kaskutas et al.[11]	Limited foreman-to-crew communication on safety priorities led to inconsistent safety practices.	Implement tailored TBTs addressing site-specific hazards with active crew participation.	Construction(residential)
Olson et al. [13]	Supervisor was reluctant to adopt new materials due to time constraints.	Use simplified visual aids like line drawings to improve hazard identification and efficiency. Brief, formatted, and scripted TBTs save time and work well for supervisors.	Construction (residential)
Kaskutas et al.[11]	Safety communication gaps persisted between foremen and crewmembers.	Increase frequency of TBTs and reinforce messages using hands-on training and demonstrations.	Construction (residential)
Kaskutas et al. [9]	Inconsistent communication practices among foremen reduced safety engagement.	Conduct foremen-led TBTs with a focus on hazard-specific mentoring.	Construction (residential)
Harrington et al.[25]	Lack of supervisor training in participatory techniques limited TBT effectiveness.	Train supervisors in participatory methods to encourage worker engagement.	Construction
Sparer et al.[32]	Resistance to site-wide recognition programs from subcontractors.	Use team-wide recognition initiatives to reinforce positive safety behaviors and communication.	Construction (commercial)
Harrington et al.[25]	Worker disengagement during standard TBTs due to lack of participatory elements.	Train supervisors using participatory models to foster engagement during TBTs.	Construction

). Harrington et al. noted that the presence of disengaged supervisors reduced the overall impact of the intervention [25].

Language barriers and cultural differences also presented significant obstacles, particularly in multi-lingual workforces such as construction. These issues negatively affected comprehension and participation, as noted by Caban-Martinez et al. [27].

High worker turnover and transient workforces posed another challenge. These factors disrupted the continuity of TBT programs, making it difficult to reinforce lessons over time. This issue was highlighted by Kaskutas et al. and Al-Shabbani [11,12,23]. Furthermore, production pressures and scheduling difficulties made it difficult for supervisors to deliver TBTs [14,31,32].

Finally, insufficient supervisor training in delivering TBTs using interactive methods hindered engagement and diluted impact. Both Harrington et al. and Kaskutas et al. emphasized the importance of equipping supervisors with communication and facilitation skills to maximize the benefits of TBTs [9,25].

3.4. Best Practices Identified

Despite these challenges, common themes were identified among several studies that reported enhanced TBT effectiveness. Tailoring TBT content to worker experience and cultural context was associated with improved worker engagement and knowledge retention, particularly in ethnically diverse settings [24,27].

The use of visual tools, such as line drawings, was recommended to improve hazard identification and reduce supervisor resistance to implementing new materials [14]. Additionally, narrative-based TBTs helped make safety messages relatable and engaging [14,15], while small-group discussions helped to reinforce fall prevention, improve communication, and create a sense of shared responsibility [11,13,14,15]. Supervisor training in participatory techniques further enhanced worker engagement and communication [9,25].

To address logistical barriers, several studies recommended scheduling TBTs at shift starts and aligning them with daily tasks [24]. For transient workforces, task-specific daily TBTs were found to be effective in reinforcing key messages [23]. Lastly, recognition programs and team-based reinforcement strategies helped foster a positive safety culture and sustained worker participation [29,32].

4. Discussion

This scoping review affirms the effectiveness of TBTs as a dynamic OSH intervention, particularly in high-risk occupations. TBTs were associated with measurable improvements across four domains: SK, SAB, SB, and broader HO. These domains collectively demonstrate that when well executed, TBTs enhance workplace safety by improving hazard recognition, fostering worker participation, and bolstering safety communication.

In general, these outcomes mirror findings from occupational studies involving work safety training interventions and increased cognitive awareness. For example, interactive approaches that engaged workers in problem-solving discussions consistently demonstrated the greatest impact on knowledge retention and ownership of safety practices [12]. In another TBT study, the use of tailored visual aids, such as line drawings, and scripted TBTs concerning high-risk tasks further validated the hypothesis by improving hazard identification and reducing unsafe practices [14]. Other approaches innovative delivery methods including text-messaging and narrative-driven TBTs expanded the scope of traditional training methods, addressing logistical challenges and enhancing engagement for diverse worker groups. Such findings support adaptive and innovative strategies to overcome barriers to training delivery, such as the transient nature of worksites or limited access to in-person sessions [14,15,26,28].

Although not initially anticipated, several studies revealed broader organizational benefits of TBTs, including enhanced team cohesion and a stronger work safety climate, particularly when TBTs were embedded within the larger safety communication frameworks [29]. These findings suggest that, beyond individual-level outcomes, TBTs can serve as catalysts for collective behavioral change and cultural reinforcement within worksites. Conversely, challenges such as workers’ disengagement, language barriers, and production pressures continue to limit the effectiveness of TBT interventions. These barriers highlight the need for structured supervisory training and the development of culturally and linguistically tailored materials to ensure inclusive communication and engagement [25]. Additionally, resistance to training among experienced workers and the logistical difficulties of high workforce turnover reflect deeper systemic issues that extend beyond TBTs alone.

While the presence of implementation barriers was anticipated, their scope and persistence across studies underscore the need for innovative and adaptive strategies to sustain impact. Approaches such as gamification, mobile-based delivery platforms, and portable training records offer promising solutions to increase accessibility, consistency, and engagement. Ultimately, while TBTs have been validated as an effective OSH intervention, their full potential can only be realized through continuous refinement and alignment with evolving workforce demographics, industry practices, and workplace safety culture.

4.1. Practical Implications

The practical implications of these findings suggest that TBTs can serve as a cornerstone for enhancing workplace safety by addressing multiple dimensions of occupational safety and health simultaneously. Organizations can leverage TBTs to foster a culture of continuous learning and proactive hazard management, particularly in high-risk industries such as construction, agriculture, mining, and manufacturing. This evidence highlights the need to tailor TBT content to specific job roles and risks, integrate participatory methods to improve worker engagement, and use innovative tools like narratives or visual aids to enhance knowledge retention and application. Additionally, addressing language and cultural barriers through multilingual materials can ensure inclusivity, making safety training accessible to diverse workforces. By embedding TBTs into broader safety communication frameworks and aligning them with organizational safety goals, employers can not only improve compliance but also create a collaborative environment where safety is a shared responsibility. These strategies have the potential to reduce injuries, increase worker morale, and drive long-term improvements in workplace safety outcomes.

4.2. Limitations

This review is limited by the variability in study designs, methodologies, and outcome measures, complicating cross-study comparisons. The exclusion of non-English studies may have omitted valuable insights, particularly from non-English-speaking regions and industry reports. Additionally, inconsistent terminology across sectors (e.g., “Safety Moments”, “Tailgate Talks”, or “Safety Huddles”) and database indexing inconsistencies may have limited the identification of relevant studies. The authors acknowledge that some studies incorporated TBTs as a component of a multi-phase intervention. In those cases, the authors reported only the effectiveness outcome measures of the TBTs, and in some studies, it was difficult to differentiate between categories when reporting. The review primarily focused on the construction and manufacturing industries, limiting generalizability to other sectors. Despite limitations such as long-term evaluations and inherent publication bias, this scoping review offers actionable guidance for implementation. Future research on TBTs should explore standardizing outcome measures and evaluating long-term post-TBT intervention health impacts, particularly among diverse industries, underrepresented regions, and non-English speaking workers and workplaces.

5. Conclusions

The findings of this scoping review highlight TBTs as an effective supplemental intervention tool for improving worker safety knowledge, shaping positive safety attitudes and promoting safe behaviors across a variety of high-risk work settings. TBTs enable supervisors to deliver concise, relevant, and site-specific safety messages, making them a practical and effective means of both introducing and reinforcing safety culture in the workplace.

Comparable practices, such as “Safety Moments”, often used in the processing industry and held at the start of meetings, illustrate how the core principles of TBTs can be adapted beyond field settings to engage a broader range of occupations and industries.

Addressing the persistent barriers that limit the consistent implementation and long-term effectiveness of TBTs will require innovative, inclusive, and adaptive approaches. By integrating emerging technologies, enhancing supervisor training, and developing culturally tailored content, TBTs can evolve into dynamic tools capable of meeting the demands of modern, diverse worksites.

To fully realize the potential of TBTs as a scalable, evidence-based safety intervention for today’s diverse workplaces, future research should focus on identifying optimal delivery methods, evaluating long-term effectiveness, and developing standardized outcome measures, including health-related indicators, to ensure consistent impact and broader applicability.