A Cluster Randomized Controlled Trial of a Total Worker Health® Intervention on Commercial Construction Sites
A Cluster Randomized Controlled Trial of a Total Worker Health® Intervention on Commercial Construction Sites
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DOI：
10.3390/ijerph15112354
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发表时间：
2018-11-01
影响因子：
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通讯作者：
Dennerlein, Jack T.
中科院分区：
文献类型：
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作者：
Peters, Susan E.;Grant, Michael P.;Dennerlein, Jack T.
这项研究评估了一项名为“All the Right Moves”的综合全面员工健康(R)计划的效果，该计划旨在通过人体工程学计划与以工作场所为基础的健康促进健康周干预相结合，针对工作条件和工人的健康行为。配对整群随机对照试验在10个工作地点(5个干预(n=324)和5个对照(n=283))进行。在暴露前和暴露后1个月和6个月在所有地点收集工人调查。线性和Logistic回归模型评估了干预对疼痛和伤害、饮食和体力活动行为、吸烟、人体工程学实践和工作限制的影响。工人焦点小组和经理访谈补充了评估。在控制了匹配的干预和对照对以及协变量后，在人体工程学计划结束后的一个月里，我们观察到干预组的人体工程学实践有了显著的改善(B=0.2，p=0.002)，疼痛和损伤的发生率降低(OR=0.58，p=0.012)。在6个月后，我们观察到干预组在减少体力工作(B=-0.25P=0.008)、增加娱乐性体力活动(B=35.2P=0.026)和更多食用水果和蔬菜(B=0.87P=0.008)方面存在差异。过程评估揭示了干预实施的保真度和接受度的障碍，包括多雇主工作场所的裂痕、工人的流动性质、相互竞争的生产压力、管理支持和恶劣天气。All the Right Moves计划在个人层面上对具有该计划的工作地点产生了积极影响。从较长期来看，需要考虑建筑工作环境中的多组织结构，以促进更上游、更长期的变化。
This study evaluated the efficacy of an integrated Total Worker Health (R) program, "All the Right Moves", designed to target the conditions of work and workers' health behaviors through an ergonomics program combined with a worksite-based health promotion Health Week intervention. A matched-pair cluster randomized controlled trial was conducted on ten worksites (five intervention (n = 324); five control sites (n = 283)). Worker surveys were collected at all sites pre- and post-exposure at one- and six-months. Linear and logistic regression models evaluated the effect of the intervention on pain and injury, dietary and physical activity behaviors, smoking, ergonomic practices, and work limitations. Worker focus groups and manager interviews supplemented the evaluation. After controlling for matched intervention and control pairs as well as covariates, at one-month following the ergonomics program we observed a significant improvement in ergonomic practices (B = 0.20, p = 0.002), and a reduction in incidences of pain and injury (OR = 0.58, p = 0.012) in the intervention group. At six months, we observed differences in favor of the intervention group for a reduction in physically demanding work (B = -0.25, p = 0.008), increased recreational physical activity (B = 35.2, p = 0.026) and higher consumption of fruits and vegetables (B = 0.87, p = 0.008). Process evaluation revealed barriers to intervention implementation fidelity and uptake, including a fissured multiemployer worksite, the itinerant nature of workers, competing production pressures, management support, and inclement weather. The All the Right Moves program had a positive impact at the individual level on the worksites with the program. For the longer term, the multi-organizational structure in the construction work environment needs to be considered to facilitate more upstream, long-term changes.