Identification of factors affecting EMS workers adoption of MSD interventions

描述（由申请人提供）：本项目的长期目标是防止紧急医疗服务（EMS）工作人员的肌肉骨骼损伤。我们小组和其他人先前的工作表明，EMS任务包含许多与文献中的肌肉骨骼疾病（MSD）相关的风险因素。在先前资助的NIOSH研究中，重点是干预设计和开发，我们建立了两个低成本和生物力学有效的原型设备，用于辅助仰卧和坐姿患者的侧向转移。桥板减少摩擦，并在其中促进患者在表面之间滑动。转移吊索提供了固定和移动就座患者的把手。可用性测试进一步将这些概念细化为商业上可行的产品。我们知道，精心设计和有效的干预措施并不能确保受影响的工人采用和持续使用这些措施。因此，当前应用程序的主要目的是进一步了解围绕旨在预防MSD的自愿干预措施的采用和可持续性的研究实践（r2 p）问题。项目目标：1.使用综合技术接受模型和任务技术匹配模型的框架作为起点，我们将确定和量化特定感知和态度因素对采用和持续使用先前验证的肌肉骨骼疾病（MSD）干预措施的贡献程度; 2.量化加强和“拥护”干预措施的个人对干预措施的采用和持续使用的影响程度，并确定成功努力的性质;从数量和地理上描述EMS组织内部和之间两种特定肌肉骨骼干预措施的扩散特征。方法.我们建议招聘108名专业EMS工作人员，并进行为期3个月的跟进。在基线时，在接受干预措施后和此后每月，将对参与者进行调查，以评估对干预措施的态度和看法（目标1）。此外，将要求参与者每周报告他们使用干预措施的情况。这些数据将被用来评估这些感知和态度因素对实际干预措施的采用和使用的相对影响，使用来自文献的理论路径模型。当每个参与者完成他们的参与时，他们将被问到他们或其他人是否以及如何“支持”干预措施（目标2）。这些数据将用于扩展目标1中使用的路径模型。最后，我们将通过跟踪购买数据（目标3）来研究组织内部和组织之间的MSD干预扩散模式。总之，这些目标将使我们能够确定旨在促进采用和传播经验证的MSD干预措施的次级干预措施的机会。 公共卫生相关性：扭伤、拉伤和肌肉疼痛占消防员/护理人员在执行非火灾紧急任务（如紧急医疗服务（EMS））时所受伤害的一半以上，因此需要有效的干预措施来改善和保护EMS工作人员的肌肉骨骼健康。在我们先前设计和测试辅助设备的研究基础上，该项目旨在了解有助于采用和持续使用干预措施的因素，这些干预措施可以减轻这类和其他工人群体的肌肉骨骼疾病负担。

DESCRIPTION (provided by applicant): The long-term goal of this project is to prevent musculoskeletal injuries in Emergency Medical Service (EMS) workers. Prior work by our group and others has shown that EMS tasks contain many risk factors that have been associated with musculoskeletal disorders (MSDs) in the literature. In a previously funded NIOSH study focused on intervention design and development, we built two low-cost and biomechanically effective prototype devices for assisting in the lateral transfer of supine and seated patients. The bridgeboard reduces friction and therein promotes sliding patients between surfaces. The transfer sling provides handholds for securing and moving seated patients. Usability testing further refined these concepts into commercially viable products. We know that having well designed and validated interventions does not ensure their adoption and sustained use by affected workers. Hence the primary purpose of the current application is to further our understanding of research to practice (r2p) issues surrounding the adoption and sustainability of voluntary interventions aimed at preventing MSDs. Project Aims: 1. Using the framework of the integrated technology acceptance model and task technology fit model as a starting point, we will identify and quantify the degree to which specific perceptual and attitudinal factors contribute to the adoption and sustained use of previously validated musculoskeletal disorder (MSD) interventions; 2. To quantify the degree to which individuals who step up and "champion" an intervention affect the adoption and sustained use of the intervention and to determine the nature of the successful efforts; 3. To characterize, both quantitatively and geographically, the diffusion of two specific musculoskeletal interventions within and between EMS organizations. Methods. We propose to recruit and follow 108 professional EMS workers for a 3-month period. At baseline, upon receiving the interventions and monthly thereafter, the participants will be surveyed to assess attitudes and perceptions about the interventions (Aim 1). In addition, participants will be asked to report their use of the interventions on a weekly basis. These data will be used to assess the relative effects of these perceptual and attitudinal factors on actual intervention adoption and use using a theoretical path model derived from the literature. As each participant completes their involvement, they will be asked if and how they or other individuals "championed" the interventions (Aim 2). These data will be used to expand the path model used in Aim 1. Finally, we will study the patterns of MSD intervention diffusion within and between organizations by tracking purchase data (Aim 3). Taken together, these aims will allow us to identify opportunities for secondary interventions aimed at facilitating the adoption and diffusion of validated MSD interventions. PUBLIC HEALTH RELEVANCE: Sprains, strains, and muscular pain account for over half of the injuries suffered by firefighter/ paramedics while performing non-fire emergency tasks, such as emergency medical services (EMS), and consequently there is a need for effective interventions to improve and protect the musculoskeletal health of EMS workers. Building on our prior research that designed and tested assistive devices, this project is aimed at understanding the factors that contribute to the adoption and sustained use of interventions that can reduce the burden of musculoskeletal disorders among this and other groups of workers.