Transdisciplinary Approaches to

Occupational Safety and Health

Research and Practice

Pietra Check, MPH

National Institute for Occupational Safety and Health

Invited Lecture, Virginia Polytechnic Institute

September 28, 2012

The findings and conclusions in this presentation are those of the author

and do not necessarily represent the views of the National Institute for

Occupational Safety and Health.

Outline

• Research Translation and Research to Practice

• Work as a social determinant of health

• Team research

• Team research in occupational safety and health

• Example: NIOSH partnership with Mexican Ministry of Foreign Affairs

• Example: Safety Pays, Falls Cost construction campaign

• Questions

Problem

“Why aren’t we realizing more substantial

clinical benefits from this explosion of

discovery? When will we see sustained and

tangible improvements in human health?”

Disis & Slattery (2010) Science Translational

Medicine 2(22):22cm9 1-4, p. 1.

www.stm.sciencemag.org

Translational Research/

Research Translation

• Began with NIH: “bench to bedside”

• Emerging:

– Public health impact

– Specific health outcomes

– Healthcare innovations

– Reductions in disparities

– Economics

– Policy changes

The Research Continuum

Changes in Policy & Practice

Basic Research & Surveillance

Applied Research

Evaluation

Communication of Results

Research to Practice

A collaborative process between NIOSH and its

partners that combines the generation of

knowledge with the adoption of that knowledge

in the workplace to reduce worker injury and

illness.

Work is a Social Determinant of Health

“…the conditions in which people are born,

grow, live, work and age… These

circumstances are shaped by the distribution

of money, power and resources at global,

national and local levels, which are

themselves influenced by policy choices…”

-WHO

www.who.int

Social-Ecological FrameworkIndividual

Interpersonal

Community

Society

Transdisciplinary Research

• Bridges knowledge and action

• Issue-driven

• Integration of perspectives, theories,

approaches results in a new framework

• Collaboration between disciplines, non-

researchers, stakeholders etc.

• All expertise weighted equally

Barriers

• Infrastructure

– Funding

– Publications

– Silos

• Vocabulary and other communication issues

• “Culture” barriers between disciplines,

between academic and non-academic

• Loss of “control” by researchers

Benefits

• Generate better understanding of complex

problems, social issues

• Identify promising solutions and actions

• Move research into practice more quickly and

effectively

Research Translation in OSH

• End-user orientation

• Engaging stakeholders to improve the

relevance, quality, and impact of research

• Evaluation

• Practice

Engaging Stakeholders & End-Users

• Community-based participatory research

• Participatory action research

• Participatory research

• Action research

• Partnership

• Advisory Committees

• Consultations

Example: NIOSH Partnership with

Mexican Ministry of Foreign Affairs

• Transdisciplinary team:

– Anthropology

– Psychology

– Industrial Hygiene

– Public Health

– Immigrant issues, community groups

– Promotores de salud

– Health Communications

– International Cooperation & Development

– Migrant Health & Epidemiology

Goal

To integrate occupational safety and health as a

key subject area into the health promotion

infrastructure of the Mexican Consulates in the

US

Expected Outcomes

• Series of education/awareness materials on

OSH

• Training curriculum for promotores de salud,

other health promotion staff

• Improved & expanded network of OSH service

providers

• Enhanced equity for workers

• Replication of the model

Research Methods

• Behavior change/communication theory

• Observation

• Active Listening

• Key Informant Interviews

• Cognitive Testing

• Subject matter expert consultation

• Peer & stakeholder review

• Intercept interviews

• Pilot testing

Cover

Inside

Unexpected Outcomes

• Individual consulates requested assistance (2

independent events) re: potential clusters

• Contributed to survey instruments, will

request data stripped of identifiers

• Participation on consultation & advisory

committees for health promotion program

• Collaboration between health promotion &

legal protection departments

Success?

• Difficult to measure

• Non-traditional outcomes

• To whom are we responsive?

“If teams cannot critically evaluate their own

innovations in a safe, shared, intellectual space,

they are doomed.” Disis & Slattery (2010) p.3

Example: Safety Pays, Falls Cost

Transdisciplinary team:

• OSH researchers, epidemiologists

• Safety and health professionals, regulators

• Trade associations

• Labor representatives

• Other industry groups

• Health communications

• Social marketing and public affairs

Goal

To provide small residential construction

contractors/owners the information, motivation,

and support they need to create the necessary

conditions for their workers to work safely at

heights.

Intended Audience

Primary:

• Contractors/owners of small residential firms

Secondary:

• Foremen/supervisors

Tertiary:

• Workers

Values

• Evidence-based campaign

• Sector Council-led

• Evaluation essential to demonstrate success

Process – Formative Research

• Environmental Scan

• Focus group study

– 15 focus groups in 4 cities

– Small residential contractors, or their

supervisors/foremen (6 groups)

– English-speaking workers (6 groups)

– Spanish-speaking workers (3 groups)

Process – Campaign Planning

• Contractor

– Comprehensive social marketing plan

• Sector Council team

– Choose essential and feasible activities

– Reach out to key partners

– Design initial Campaign materials & evaluation strategy

– Mobilize to plan Campaign launch & subsequent activities

Key Strategies

• Partnerships

• Media Relations

• Internet and New Media

• Advertising

• State and Local Engagement

• 360 degree outreach

– Contractors encounter the Campaign in the course of their daily lives

State and Local Engagement

• Direct outreach to intended audience

• Engage local media

• Host a local event

– Training, education, awareness

– Observance

– Equipment or practice demonstration

– Contractor-expert meet & greet

Partnerships

• State/local level

– Chambers of Commerce

– DOL-DPH

– Associations, e.g. home builders

– Businesses, e.g. distributors, retailers, rental companies

• National

– 2-3 key general partners

– National associations, unions, government

Campaign Activities

• Produce and distribute materials

• Get the word out

• Promote, host, or sponsor events

• Assist with evaluation

• Reach out to new partners

Materials

• NIOSH-OSHA Cobranded Poster & Fact Sheet

• Checklists/infographs

• Videos

• Toolbox talks

• Spot-the-Hazard Cards

• Sticker

• Partner Toolkit

• Press kit

Acknowledgements

Michael Flynn

Nura Sadeghpour

Elizabeth Garza

Josana Tonda

Javier Diaz de Leon

US-Mexico Border Health

Commission

Gudelia Rangel-Gomez

Christine Branche

Scott Schneider

Janie Gittleman

Pete Stafford

Jim Maddux

NORA Construction Sector

Council Campaign

Coordinating Committee

Questions?

Pietra Check, MPHDeputy Director, Office of Agriculture Safety and Health

Coordinator, Agriculture, Forestry & Fishing Program

National Institute for Occupational Safety and Health

Washington, DC

202.245.0660

Pcheck@cdc.gov