Profiles of total worker health® in United States small businesses

Abstract

Background The Total Worker Health® (TWH) approach is a best practice method to protect and promote worker safety, health, and well-being. Central to this approach is leadership support and health and safety climates that support day-to-day use of health and safety policies and programs. There is some research that supports these relationships, but there is limited research amongst small businesses. Furthermore, it remains to be shown what role TWH business strategies, as reflected by organizational policies and programs, play in this process. The purpose of this study is to characterize small businesses by their organizations’ TWH approach and assess the relationship of these approaches to employee health and safety behaviors. Methods We utilized cross-sectional data from 97 businesses participating in the Small+Safe+Well study. We collected data using a business assessment tool, Healthy Workplace Assessment™, and an employee assessment tool, Employee Health and Safety Culture Survey. We used latent profile analysis at the business level to identify subgroups of businesses based on a set of characteristics from these assessments. Linear regression analysis at the employee level was used to determine profile association with employee safety and health behaviors. Results There were two profiles characterized by the lowest (33% of all businesses) and highest (9%) levels of the indicators. There were also two profiles with higher scores on two of the different foci on either TWH business strategies (27%) or leadership and climate (31%). Employees working for a business with a profile that focused on leadership and climate, in addition to having a business strategy, reported the best safety and health behaviors. Conclusions Our study demonstrates that employee engagement in TWH will be highest when businesses have a strategy for how they implement a TWH approach and when they demonstrate leadership commitment to these strategies and foster positive safety and health climates. Our results offer suggestions on how to use TWH assessments to develop interventions for small businesses. More research is needed to understand whether small businesses can improve upon their profile overtime, whether these changes depend on contextual factors, and whether TWH interventions can help them improve their profile.

Leveraging an Implementation Science Framework to Measure the Impact of Efforts to Scale Out a Total Worker Health® Intervention to Employers

“…The application of implementation frameworks to provide guidance on selecting implementation strategies to fit organizational contexts has been widely embraced in the design and delivery of interventions by clinical and community organizations [24,36] However, to date, despite their promise [3], there have been few examples of applying implementation frameworks for the translation and delivery of interventions into organizational settings that require adoption and implementation at the business level to benefit working individuals [4,15,[37][38][39][40]. Specifically in relation to occupational safety and health translational research, it was noted that consideration of the unique and contextual challenges to achieving success in a workplace setting is critical in addition to finding a common language of D&I terminology [15].…”

Total Worker Health® and Small Business Employee Perceptions of Health Climate, Safety Climate, and Well-Being during COVID-19

“…During the pandemic, the ways in which leaders communicated changes, motivated employees, and showed empathy were associated with employee well-being [ 1 , 11 ]. The importance of leadership in creating a climate where employee safety and health is valued has similarly been highlighted in small businesses [ 21 , 22 , 23 ]. Our past research demonstrates a positive relationship between leadership commitment to safety and health and employees’ perceptions of safety and health climates [ 24 ] and safety and health behaviors [ 22 ].…”

“…The importance of leadership in creating a climate where employee safety and health is valued has similarly been highlighted in small businesses [ 21 , 22 , 23 ]. Our past research demonstrates a positive relationship between leadership commitment to safety and health and employees’ perceptions of safety and health climates [ 24 ] and safety and health behaviors [ 22 ].…”

“…Once the pandemic hit, we examined how the pandemic impacted perceptions of safety and health climates and employee well-being in the SSWell cohort of small businesses at two timepoints: during the early wave of COVID in May 2020 and in September 2020 as rates of illness in the U.S. began to rise again. In the present study, we aimed to extend our prior leadership and climate and climate research in small business [ 22 , 23 , 24 ].…”

Attitudes of Company Executives toward a Comprehensive Workplace Health Management—Results of an Exploratory Cross-Sectional Study in Germany

“…As this definition suggests, workplace health management is a holistic approach, and there is a strong similarity between workplace health management and the 'Total Worker Health' concept that has been promoted in the USA [5][6][7][8][9][10][11][12][13][14]. In recent years, this approach has further gained ground [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31]. Workplace health management can be differentiated into the following four subcategories [4]: (1) occupational health and safety measures, (2) management of return-to-work processes of employees who were on long-term sickness absence (in short 'reintegration management'), (3) workplace health promotion measures, and (4) supporting personnel development.…”