The Construction Intermediary Research Project had two major components. First, we conducted a longitudinal survey among apprentice construction workers to identify relationships between work organization, environmental factors, health behaviors, and health outcomes. Second, we prioritized Total Worker Health (TWH) interventions among construction contractors and unions, and then used these key intermediary organizations to disseminate TWH interventions. Longitudinal surveys (over 900 apprentices each year for three years) identified the influence of work organization and environment (job strain, coworker safety behaviors, mandatory overtime, precarious work, supervisor support) on missed work, productivity, and use of pain medications among apprentices. Analysis of cross-sectional data found that health behaviors and both health and employment outcomes were related to multiple work organization factors, including job strain, mandatory overtime, precarious work, safety behaviors of coworkers, and supervisor support for safety. Most of these relationships persisted in our longitudinal analyses. In a separate analysis we found that these factors influenced binge drinking.
We also conducted focus groups and interviews with regional construction contractors, trade unions, and apprenticeship programs to identify current workplace programs, policies, and practices affecting worker health and well-being, and to prioritize areas for intervention. We found that few employers had formal programs addressing worker health and well-being beyond traditional workplace safety. While many felt that workplace policies should not address “personal behaviors” such as smoking, suicide prevention and opioid use were identified as high priorities for intervention by all groups. Our academic team provided content, logistical support, and consultation to these intermediaries (two regional contractor associations, two union health funds, and two union apprentice training programs) to develop and deploy new educational and awareness programs around suicide, mental health, and opioid use.
To date, Associated General Contractors of Missouri has implemented a week-long suicide prevention and awareness campaign. Two union health funds have created media plans and run stories in their newsletters about suicide and opioid use, reaching approximately 23,000 members. Two union apprenticeship programs will provide opioid use prevention training (developed with our team) for all new apprentices. Evaluation of these programs is ongoing, including the reach and uptake of awareness efforts and changes in knowledge and attitudes. This study established partnerships with trusted intermediary organizations, and showed that these can be an effective way to disseminate health information to high-risk worker groups. These materials were disseminated throughout the region.
Evanoff BA, Rohlman D, Strickland JR, Kelly KM, Dale AM. (2018, April-May). “Influence of work organization and environment on health behaviors of construction apprentices.” Presented at the 32nd International Congress on Occupational Health, Dublin, Ireland.
Dale AM, Welch L, Evanoff BA. (2018, April-May). “Participatory ergonomic programs in commercial construction projects: Engagement with multiple organizational levels to improve effectiveness.” Presented at the 32nd International Congress on Occupational Health, Dublin, Ireland.
Dale AM, Rohlman DS, Strickland JR, Kelly KM, Evanoff BA. (2018, May). “Contrasting Prevalence of Health and Safety Risks and Controls between Residential and Commercial Construction Apprentices.” Presented at the 2nd International Symposium to Advance Total Worker Health, Bethesda, MD.
Evanoff BA, Rohlman, DS, Strickland JR, Kelly KM, Dale AM. (2018, May). “Influence of work organization and environment on health behaviors of construction apprentices.” Presented at the 2nd International Symposium to Advance Total Worker Health, Bethesda, MD.
Evanoff BA, Rohlman DS, Strickland JR, Kelly KM, Dale AM. (2018, October). “Influence of work organization and environment on health and productivity outcomes among construction apprentices: A Total Worker Health® approach.” Presented at the 7th National Occupational Injury Research Symposium (NOIRS), Morgantown, WV.
Rohlman DS, Stickland J. (2018, October). “Influence of work organization and environment on health behaviors.” Presented at the 15th Annual Greater St. Louis Safety & Health Conference, St. Louis, MO.
Dale AM, Rohlman DS, Strickland JR, Kelly KM, Evanoff BA. (2019, February). “Contrasting Prevalence of Health and Safety Risks and Controls between Residential and Commercial Construction Apprentices.” Webinar presented with the Work Wellness Disability
Prevention Institute.
Rohlman DS. (2019, February). “Total Worker Health: An Example with Construction Apprentices.” Presented at the Department of Occupational and Environmental Health Seminar, Iowa City, IA.
Evanoff BA, Rohlman DS, Strickland JR, Kelly KM, Dale AM. Influence of work organization and environment on health and productivity outcomes among construction apprentices: A Total Worker Health approach. 27th International Epidemiology in Occupational Health Conference (EPICOH), Aotearoa, New Zealand. 2019.
Rohlman DS, Evanoff, BA, Kelly KM, Strickland JM, Dale AM. The Impact of Work Organization and Work Environment on Health Behaviors of Construction Apprentices. 13th International Conference on Work, Stress and Health 2019, American Psychological Association, Philadelphia, PA. 2019.
