Center for the Promotion of Health in the New England Workplace (CPHNEW), University of Massachusetts Lowell, Lowell, MA 01854, USA.
Center for Human Sexuality Studies, Widener University, Chester, PA 19013, USA.
Int J Environ Res Public Health. 2019 Apr 27;16(9):1494. doi: 10.3390/ijerph16091494.
Organizational features of work often pose obstacles to workforce health, and a participatory change process may address those obstacles. In this research, an intervention program sought to integrate occupational safety and health (OSH) with health promotion (HP) in three skilled nursing facilities. Three facilities with pre-existing HP programs served as control sites. The intervention was evaluated after 3-4 years through focus groups, interviews, surveys, and researcher observations. We assessed process fidelity in the intervention sites and compared the two groups on the scope of topics covered (integration), program impact, and medium-term sustainability. The intervention met with initial success as workers readily accepted and operationalized the concept of OSH/HP integration in all three intervention facilities. Process fidelity was high at first but diminished over time. At follow-up, team members in two intervention sites reported higher employee engagement and more attention to organizational issues. Two of the three control facilities remained status quo, with little OSH/HP integration. The intervention had limited but positive impact on the work environment and health climate: staff awareness and participation in activities, and organizational factors such as decision-making, respect, communication, and sharing of opinions improved slightly in all intervention sites. Resources available to the teams, management support, and changing corporate priorities affected potential program sustainability.
工作组织特征常常对员工健康构成障碍，而参与式变革过程可能会解决这些障碍。在这项研究中，一个干预项目试图将职业安全与健康（OSH）与健康促进（HP）在三个熟练护理设施中结合起来。三个具有预先存在的 HP 计划的设施作为对照点。该干预措施在 3-4 年后通过焦点小组、访谈、调查和研究人员观察进行了评估。我们评估了干预点的过程保真度，并比较了两组在涵盖的主题范围（整合）、计划影响和中期可持续性方面的情况。该干预措施最初取得了成功，因为工人很容易接受并在所有三个干预设施中实施了 OSH/HP 整合的概念。最初的过程保真度很高，但随着时间的推移而降低。在随访时，两个干预点的团队成员报告了更高的员工参与度和对组织问题的更多关注。三个对照设施中的两个仍保持现状，OSH/HP 整合很少。该干预措施对工作环境和健康氛围产生了有限但积极的影响：所有干预点的员工意识和参与度以及组织因素（如决策、尊重、沟通和意见分享）都略有改善。团队可用的资源、管理支持和不断变化的公司优先事项影响了潜在的项目可持续性。
