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Total Worker Health in Action: July 2017

Advancing worker safety, health, and well-being

Volume 6 Number 2 July 2017

Managers’ Buzz

Anita L. Schill, PhD, MA, MPH, and L. Casey Chosewood, MD, MPH

Anita Schill and Chosewood

Over halfway through 2017, we are thinking about what has already been accomplished this year to move the concept of Total Worker Health forward, as well as what’s to come in the months ahead. Representatives from the Office for Total Worker Health and from our NIOSH Centers of Excellence for Total Worker Health participated in the recent Work, Stress, and Health conference and the NORA State of the Science Meeting. Each of these events provided an opportunity to share TWH concepts with researchers and practitioners committed to improving worker safety, health, and well-being. They also provided valuable insight into topics and areas of interest for our own upcoming 2nd International Symposium to Advance Total Worker Health, happening May 8–11, 2018, at the NIH Natcher Center in Bethesda, MD. We hope you’ll join us and contribute to the symposium by submitting an abstract. Learn more about topics for the symposium in Updates from the Office for TWH.

The University of Iowa hosted a Research Methodology Workshop for TWH guiding our efforts to strengthen the quality and consistency of TWH research. Workshop initiatives will address gaps in TWH research as well as advance TWH science and practice. Training the future leaders in TWH is no small feat, and another TWH-focused event is aiming to do just that. A Training and Education Roundtable will occur this fall at The University of North Carolina at Chapel Hill, with the goal of developing a curriculum for and training future TWH workforce professionals. Read more about these key events in Updates from the Office for TWH and the TWH Exclusive.

We invite you to stay up-to-date on the latest Total Worker Health news, research, events, and more by joining the conversation on Twitter (@NIOSH_TWH), on the NIOSH Total Worker Health LinkedIn Group, or by email at

Total Worker Health Exclusive

Training the Future: TWH Professionals
Dr. Adele Childress, Workforce Development Lead, NIOSH Office for Total Worker Health

What’s new in the NIOSH Total Worker Heath® professional development initiative? A strategic goal outlined in the National Agenda to Advance Total Worker Health® Research, Practice, Policy, and Capacity is to identify educational and training needs for building the skills and abilities of existing and future occupational safety and health and allied professionals that will allow them to incorporate TWH strategies and interventions into the workplaces they serve.

In May 2016, the NIOSH Office for TWH mailed a training questionnaire to NIOSH-funded academic research centers to assess the interest and demands for creating specialized TWH-focused course material. Results from 58 respondents indicated that there is interest in incorporating TWH concepts into seminars, workshops, continuing education, and graduate and undergraduate courses across various disciplines. Overall, 97% of responding institutions said that they would be interested in participating in a future workshop on TWH workforce development and capacity building.

In November 2017, The University of North Carolina at Chapel Hill (UNC), in partnership with NIOSH TWH, will host a roundtable discussion with scientists, educators, workplace professionals, and other partners. Drs. Bonnie Rogers (UNC) and Deborah McLellan (Harvard University) will plan and co-chair the meeting. Education professionals from a variety of institutions will be addressing needs in three areas: identify core competencies for TWH practitioners; better develop the business rationale for jobs focused in TWH; and find innovative ways to reach partners and target audiences interested in implementing TWH. A primary goal is to develop a set of options for how to design and implement training and education programs for TWH that will reach desired professional audiences with maximum impact. This and other outcomes of the roundtable are expected to guide strategic planning over the next 1–2 years. To seek wider input from professionals in the field, a sequel to this roundtable will be held during the 2nd International Symposium to Advance TWH on the NIH campus in Bethesda, Maryland, May 8–11, 2018.

Updates from the NIOSH Office for Total Worker Health

symposium BANNER 2018

Abstract Submission Opening Soon for 2nd International Symposium to Advance Total Worker Health®

The 2nd International Symposium to Advance Total Worker Health is scheduled for May 8–11, 2018, at the NIH campuses in Bethesda, MD. Abstract submission will open soon and remain open until October. Topics for the Symposium include but are not limited to the following:

  • Workplace risks and health outcomes
  • Health and the work environment – Optimizing organizational policies and practices
  • Approaches to supervision and employee relations and links to health
  • Changing workforce demographics
  • Work-life continuum and implications for well-being
  • Work design and new technologies
  • Globalization and the international economy: Implications for Total Worker Health
  • Partnerships and collaborations
  • Advancing the state of the science for Total Worker Health: Methods for research and interventions
symposium Goals 2018


TWH Research Methodology Workshop: Updates and Report

In early March, the University of Iowa Healthier Workforce Center of the Midwest brought together more than 20 national experts to discuss TWH research methodologies and approaches. As a result of the TWH Research Methodology Workshop, participants are developing a peer-reviewed manuscript on their work to help current and future researchers in the field. Six areas of emphasis for the manuscript include:

  • The advantages, disadvantages and limitations of different designs for TWH research as demonstrated by case-studies,
  • Appropriate control or comparison groups in studies assessing the efficacy and effectiveness of TWH interventions,
  • Appropriate methods to address potential selection bias, high attrition (including non-response), and unanticipated changes to the work environment,
  • The role of qualitative and mixed-method approaches in TWH research and how these can be utilized to address a variety of types and sizes of organizations, businesses, occupations and industries,
  • Review of compiled measures and outcomes from TWH studies, and
  • Development of a core set of outcomes and measures addressing health, safety, utilization, occupational injury and illness surveillance, well-being and intermediate outcomes.

Updates from the NIOSH National Center for Productive Aging and Work (NCPAW)

On April 27, NCPAW co-directors Jim Grosch and Juliann Scholl gave an invited presentation to the American Association of Occupational Health Nurses (AAOHN). The presentation reviewed the aging workforce landscape in the United States and the current work by NCPAW and the Office for Total Worker Health®. They also highlighted NCPAW’s productive aging model and discussed strategies for creating age-friendly workplaces. For more information on the aging workforce and designing age-friendly workplaces for the healthcare industry, check out the following practical tools, videos, and digital stories developed with support of NIOSH and other organizations.

Spotlight on NIOSH Fundamentals of Total Worker Health Approaches

cover sheet Fundamentals

Defining Element 1: Leadership Commitment to Worker Safety and Health

Leadership commitment to safety and health is the first defining element of Total Worker Health®. Organizations need critical support from top leaders to maintain the visibility of programs and initiatives, but most importantly, to prioritize worker safety and health. Top leaders also play a key role in ensuring that mid-level management is actively engaged and committed to worker safety and health initiatives. Managers are crucial in efforts to encourage workers’ feedback on work conditions and in rewarding all members of the team committed to workers’ safety and health.

Additionally, quality of leadership has a strong relationship with effectively engaging and motivating workers.1 When employees are engaged and motivated, programs are more effective and sustainable in the long term. The tone leaders set within an organization also has direct implications for the health and well-being of workers.

To learn more about the role of leadership commitment to worker safety and health in your organization’s path toward Total Worker Health, visit the Fundamentals of TWH Approaches webpage. For additional information supporting this Defining Element of TWH from the NIOSH Centers of Excellence for TWH, view the following resources:

1. Scott and McMullen, 2010

Updates from the NIOSH Centers of Excellence for Total Worker Health

Center for Promotion of Health in the New England Workplace (CPH-NEW)

Since 2015, CPH-NEW TWH Center at UMass Lowell has been program evaluator for a Massachusetts Department of Public Health (MDPH) statewide initiative, “Working on Wellness” (WoW). Collaborating with MDPH, University of MA Medical School, and program provider Health Resources in Action, Inc., CPH-NEW has helped the WoW program incorporate Total Worker Health in data collection and program planning tools for employers. The WoW website features a Healthy Workplace Toolbox for employers to access “how to” materials as well as recorded educational webinars on a range of workplace health topics. Check out the Healthy Workplace Toolbox and the Expert Series (webinars) at

CPH-NEW, in partnership with St. Louis University, is sponsoring a second National Symposium for Correctional Worker Health on August 17, 2017, at St. Louis University Law School. This meeting will bring together correctional leaders, correctional officers, and university researchers to advance research, programs, and policies for correctional officer health and well-being. Learn more at the CPH-NEW Events page.

Harvard T.H. Chan School of Public Health Center for Work, Health, and Well-Being

The Harvard T.H. Chan School of Public Health Center for Work, Health, and Well-Being has been collaborating with the Boston Fire Department and the Boston Firefighters Local 718 to examine factors in the fire station that may be impacting firefighter cancer risk. As a first step, the Center’s team completed a pilot study focusing on air quality in fire stations. Findings from the pilot demonstrated that on average, contaminant levels were higher in the truck bays, when compared to those in the station kitchens or outside measurements, and that levels in the truck bays varied considerably throughout the day. Building age, station layout, and ventilation appeared to impact contaminant levels in the fire station. The data will be presented at two national conferences in June. The team is currently building on the pilot study to examine how other aspects of the fire station, including organizational, environmental, and behavioral factors, may influence firefighter health. This work will help inform a future Total Worker Health intervention aimed at reducing cancer-related risk factors at the fire station.

University of Iowa Healthier Workforce Center of the Midwest (HWCMW)

Through a community-based pilot project grant funded by HWCMW, the St. Louis Area Business Health Coalition (BHC) recently created and released the Total Worker Health® Employer Guide. It includes TWH education and resources for employers to address topics such as workplace hazards, interpersonal relationships, work organization, and professional development. The guide was disseminated during the BHC Spring Forum, where HWCMW Director Dr. Diane Rohlman delivered the keynote address on Fundamentals of TWH to 150 business leaders within the coalition. Initial feedback on the employer guide has been positive, with two-thirds of surveyed attendees indicating that they are likely or very likely to implement TWH approaches in their workplace or client’s workplace. “As organizations look for strategies to help employees thrive in the modern work environment, Total Worker Health research will continue to provide the scientific support and actionable resources necessary to advance well-being on the job,” says Lauren Schulte, Senior Manager of Wellness Services for the BHC.

In addition, through its partnership with The Heartland Center for Occupational Health and Safety, a NIOSH Education and Research Center, HWCMW will co-host the Hawkeye on Safety conference on September 20. Topics will include industrial hygiene, occupational safety, and workplace well-being. Other collaborations with The Heartland Center this past spring have included the Occupational Health Symposium and Occupational Health and Safety Student Research Conference. Stay connected to HWCMW on Twitter and Facebook.

Oregon Healthy Workforce Center (OHWC)

The COMPASS program, dedicated to creating supporting “communities of practice” for the region’s isolated home care workers, has found an official sponsor for getting their message out more widely than ever before. The Oregon Home Care Commission has signed an extended research agreement with the Oregon Health & Science University that allows COMPASS to be offered as part of its training program. This increases the reach of the program to 60% of Oregon’s home care providers. In exchange, the Commission will provide data that will help OHWC researchers evaluate the long-term impacts of COMPASS over the next five years.

With selection wrapped up from its heavy applicant pool, the OHWC Summer Internship program kicked off in June. Interns will work with OHWC principal investigators on research projects and also gain exposure to outreach and dissemination.

Finally, learn more about OHWC by: viewing the Center’s YouTube channel; visiting the blog, Oregon and the Workplace; accessing materials in the Toolkit Kiosk and Resource Directory; and getting updates via Twitter.

University of Illinois-Chicago (UIC) Center for Healthy Work

In partnership with the American College of Occupational and Environmental Medicine (ACOEM) and Underwriters Laboratories (UL), the UIC School of Public Health has released a seven-module eLearning course, entitled Fundamentals of Integrated Health and Safety, offers strategies to improve health and safety programming using the concept of Integrated Health and Safety (IHS). IHS is an increasingly popular workplace management approach that more closely aligns the traditionally separate “silos” of workplace health and safety programs. In addition, the course provides a step-by-step manual of IHS, ranging from data collection and health and safety measurement to population health management and the details of integrating health and safety teams. Those who complete the course earn a certificate from University of Illinois-Chicago School of Public Health. ACOEM members completing the course will receive, in addition to the certificate, a customized course-related offering that will provide up to 10 hours of continuing medical education (CME) and maintenance of certification (MOC) credits. To learn more about the course or to register, visit


New Publications and Resources

Advancing well-being through Total Worker Health®

Dr. Anita Schill, of the NIOSH Office for Total Worker Health, published an article describing core TWH concepts and their potential use by occupational health nurses. The article emphasizes Total Worker Health practices as an approach to worker safety, health, and well-being that comprehensively focuses on the needs, challenges, and opportunities faced by workers as they navigate work in the 21st century.

NIOSH Research Rounds

NIOSH Research Rounds is a monthly bulletin of selected research at the National Institute for Occupational Safety and Health. July’s issue focuses on research from CPH-NEW, a NIOSH Center of Excellence for TWH.

Three New Publications from Centers of Excellence for Total Worker Health

Conceptualizing the dynamics of workplace stress: a systems-based study of nursing aides. 

Researchers at CPH-NEW investigated how changes in psychosocial perceptions and workplace factors might influence workplace stress over time, using a multidimensional system dynamics model. Results indicate that workplace interventions should aim to change organizational conditions for nursing aides.

Field tests of a participatory ergonomics toolkit for Total Worker Health. Researchers from CPH-NEW developed and tested a Healthy Workplace Participatory Program Toolkit (HWPP) combining ergonomics with worksite health promotion. They learned that program success depended on organizational commitment, subject matter expertise in ergonomics and health, and retraining committee members involved with implementation.

Injury rates before and after the implementation of a safe resident-handling program in the long-term care sector. CPH-NEW researchers collected workers’ compensation claims data from 136 nursing homes where a Safe Resident-Handling Program had been implemented. After six years of regular program use, all claims had been reduced by 72%, with resident-handling claims dropping by 82%.

Recent CPH-NEW News and Views: Emerging Topics Briefs

Issue #50: Safety Climate and the Occupational Safety and Health Management Process

Issue #51: Workplace Psycho-social Environment and Employees’ Health Behavior: More Evidence to Support the Link

Conferences, Webinars, and Training


Dr. Chosewood of the NIOSH Office for TWH at NASA’s Annual Safety and Health Day in Virginia.

Dr. Chosewood of the NIOSH Office for TWH at NASA’s Annual Safety and Health Day in Virginia.

7th to 10th—The Work, Stress, and Health 2017 international conference, in Minneapolis, Minnesota, was co-convened by NIOSH, the American Psychological Association Public Interest Directorate, and the Society for Occupational Health Psychology. Researchers from NIOSH and the NIOSH Centers of Excellence for Total Worker Health participated in various presentations and sessions.

7th to 10th—Michael Grant, of the Harvard T.H. Chan School of Public Health Center for Work, Health, and Well-being, presented at the American Industrial Hygiene Conference and Expo in Seattle, Washington. His presentation was entitled “Preliminary Results, Challenges, and Successes of Implementing a Comprehensive Ergonomics and Wellness Total Worker Health® Intervention on Commercial Construction Sites.”

8th— Dr. L. Casey Chosewood gave the keynote address to NASA’s Annual Safety and Health Day at NASA Langley in Virginia. The event is part of NASA’s year-long 100th anniversary celebration. Dr. Chosewood focused on meeting the safety and health challenges NASA is likely to face as it readies for the next century of discovery and exploration.

21st and 22nd—NIOSH launched the 3rd Decade of the National Occupational Research Agenda at its Expanding Research Partnerships: State of the Science Conference in Denver, Colorado. Representatives from the NIOSH TWH Centers of Excellence presented in various sessions.

28th—CDR Heidi Hudson, USPHS, and Chia-Chia Chang, MBA, both of the NIOSH Office for Total Worker Health, presented at the NASA Occupational Health Conference.

Chia-Chia Chang, MBA and CDR Heidi Hudson, MPH of the NIOSH Office for TWH presented at the 2017 NASA Occupational Health meeting at the Kennedy Space Center in Cape Canaveral, Florida.

Chia-Chia Chang, MBA and CDR Heidi Hudson, MPH of the NIOSH Office for TWH presented at the 2017 NASA Occupational Health meeting at the Kennedy Space Center in Cape Canaveral, Florida.


17th to 18th—Dr. Chosewood will present the keynote address and provide a TWH participatory workshop for the Queensland Government of Australia at their Health and Safety Meeting.  This year’s meeting is focused on the prevention of musculoskeletal disorders.


9th to 10th—Dr. Chosewood will speak at 4th Annual International Summit on Occupational Health and Safety, organized by Mutual de Seguridad CCHC in Santiago, Chile.  Mutual de Seguridad is the nation’s workers’ compensation authority and provides ongoing training to decrease worker injury and illness.

22nd to 24th— Dr. Chosewood will provide the August 23 Keynote Presentation at the National Ergonomics Conference and Expo in Las Vegas, NV. His presentation is entitled “A New Look at the Way We Work: Strategies From NIOSH Total Worker Health®.”


25th to 27th—The Understanding Small Enterprises Conference will take place in Denver, Colorado. Conference topics include the links between worker well-being and business health; contingent and vulnerable workers; and the interactions of partners with small businesses. Registration now open!


May 8–11, 2018—The 2nd International Symposium to Advance Total Worker Health® returns to the campus of the National Institutes of Health in Bethesda, Maryland. This is the only NIOSH-sponsored conference dedicated solely to advancing Total Worker Health research and practice. Abstract submission will open soon. Esteemed presenters from nonprofit, government, private, and academic institutions are expected to share their perspectives and research findings on Total Worker Health, as well as practical applications.


Editorial Board

  • L. Casey Chosewood, MD, MPH, Executive Editor
  • Anita L. Schill, PhD, MA, MPH, Executive Editor
  • CDR Heidi Hudson, MPH, Editor-in-Chief
  • Reid Richards, Managing Editor
  • Seleen Collins, Copy Editor
  • Tonya White, NIOSH Web Editor
  • Steve Leonard, NIOSH Web Publisher

Please send your comments and suggestions to us at

This newsletter is published quarterly via email by the National Institute for Occupational Safety and Health Total Worker Health® Program to inform members of the public health community as well as interested members of the general public of program-related news, new publications, and updates on existing activities and initiatives.