Department of Biomedical Engineering, University of Massachusetts Lowell, One University Avenue, Falmouth Hall 305F, Lowell, MA 01854, United States.
Solomont School of Nursing, University of Massachusetts Lowell, 113 Wilder Street, Suite 200, Lowell, MA 01854, United States.
Ann Work Expo Health. 2024 Jun 6;68(5):466-475. doi: 10.1093/annweh/wxae030.
Occupational Safety and Health (OSH) professionals increasingly need to assess and mitigate a broad scope of worker safety, health, and well-being concerns that extend beyond traditional OSH training curricula. Work-related and non-work-related psychosocial hazards, chronic physical and mental health conditions, and changing work arrangements call for an integrative, public health approach to occupational risk management; this approach has been called, "Total Worker Health®" by United States public health authorities (Schulte et al. 2019). OSH professionals need education to ensure that Total Worker Health (TWH) practice approaches are consistently and effectively applied. This study sought to develop a valid, reliable scale that could be used to assess TWH skills gaps that can be addressed with tailored, competency-based curricula.
We developed a survey scale to assess professional competency for specific TWH practice approaches described in prior literature (Lee et al. 2016; Punnett et al. 2020). The scale contained 11 statements and used a 5-point scale (not skilled to highly skilled) to rate the level of competency. We pre-tested and refined the statements for face validity then administered the scale with a convenience sample of 258 professionals from mixed OSH disciplines. A total of 210 OSH professionals (31% safety, 17% industrial hygiene, 12% occupational nurses, 11% occupational physicians, 29% other) who completed 50% or more of the questions were included in the analysis. Scale reliability was assessed with a Cronbach's alpha test. Scale validity and structure were assessed with exploratory factor analysis (EFA).
The 11-item scale had high internal consistency (Cronbach's α = 0.92). The initial EFA solution suggested 2 factors that explained 65.3% of variance, with one cross-loaded question. A final 10-item, 2-factor scale was developed that accounted for 66.0% of variance with no cross-loaded items (Cronbach's alpha α = 0.91). Factor 1 (6 items) contributed to 55.5% of the variance and captured skills related to TWH program leadership (e.g. leader commitment, integrating program systems, engaging with other program leaders and workers). Factor 2 (4 items) contributed to 10.5% of the variance and captured technical skills related to hazard identification and control (e.g. identifying hazards, designing work to reduce hazards). Internal consistency was very good for both TWH program leadership (Cronbach α = 0.89) and TWH risk assessment and control (Cronbach α = 0.80) subscales.
A novel 10-item TWH skill scale to assess specific TWH practice approaches was developed with very good reliability. Factor analysis revealed 2 latent constructs: TWH leadership skills and TWH risk assessment and control skills. This study offers an evidence-based tool to assess competency for specific TWH practices among OSH professionals. The results of this study contribute to the broader research base needed to formalize a TWH competency framework, as advocated by other scholars interested in TWH workforce education (Newman et al. 2020).
职业安全与健康 (OSH) 专业人员越来越需要评估和减轻广泛的工人安全、健康和福祉问题，这些问题超出了传统的 OSH 培训课程。工作相关和非工作相关的心理社会危害、慢性身心健康状况以及不断变化的工作安排需要采用综合的公共卫生方法来管理职业风险；美国公共卫生当局将这种方法称为“全面工人健康®”（Schulte 等人，2019 年）。OSH 专业人员需要接受教育，以确保全面工人健康 (TWH) 实践方法得到一致和有效地应用。本研究旨在开发一种有效的、可靠的量表，以评估 TWH 技能差距，并通过量身定制的、基于能力的课程来解决这些差距。
我们开发了一个调查量表，以评估特定 TWH 实践方法的专业能力，这些方法在先前的文献中有所描述（Lee 等人，2016 年；Punnett 等人，2020 年）。该量表包含 11 个陈述，并使用 5 点量表（从不熟练到熟练）来评估能力水平。我们进行了预测试并对陈述进行了内容有效性检验，然后对 258 名来自不同 OSH 学科的专业人员进行了量表测试。共有 210 名 OSH 专业人员（31%安全、17%工业卫生、12%职业护士、11%职业医生、29%其他）完成了 50%或更多的问题，包括在分析中。量表的可靠性通过克朗巴赫 α 测试进行评估。量表的有效性和结构通过探索性因素分析 (EFA) 进行评估。
11 项量表具有较高的内部一致性（克朗巴赫 α = 0.92）。初始 EFA 解决方案表明有两个因素可以解释 65.3%的方差，其中一个交叉加载问题。开发了一个最终的 10 项、2 因素量表，占 66.0%的方差，没有交叉加载项（克朗巴赫 α α = 0.91）。因素 1（6 项）对 55.5%的方差做出贡献，反映了与 TWH 项目领导相关的技能（例如，领导承诺、整合项目系统、与其他项目领导和工人合作）。因素 2（4 项）对 10.5%的方差做出贡献，反映了与危险识别和控制相关的技术技能（例如，识别危险、设计减少危险的工作）。TWH 项目领导（克朗巴赫 α = 0.89）和 TWH 风险评估和控制（克朗巴赫 α = 0.80）子量表的内部一致性非常好。
本研究开发了一种新颖的 10 项 TWH 技能量表，用于评估特定的 TWH 实践方法，具有很好的可靠性。因素分析显示有两个潜在的结构：TWH 领导力技能和 TWH 风险评估和控制技能。本研究提供了一种基于证据的工具，用于评估 OSH 专业人员在特定 TWH 实践方面的能力。这项研究的结果为更广泛的研究基础做出了贡献，这些研究基础是其他学者为 TWH 劳动力教育所倡导的（Newman 等人，2020 年）。
