Perceptions of HIV self-testing promotion in black barbershop businesses: implications for equitable engagement of black-owned small businesses for public health programs.

BACKGROUND: HIV self-testing (HIVST) offers an innovative and promising approach to increasing HIV testing among Black men in the United States, a population disproportionately affected by HIV. However, engaging Black men in traditional HIV prevention programs has been challenging due to stigma, medical mistrust, and limited access to preventive health services. This formative qualitative study aimed to explore the potential of utilizing barbershops as an example of a nontraditional healthcare venue to promote and distribute HIVST. METHODS: Four virtual focus group discussions (FGDs) consisting of 19 participants in North Carolina were conducted with Black men, including barbershop business owners, barbers, and their customers, to assess perceptions of HIVST and the acceptability of partnering with barbershop businesses to promote HIVST. FGDs were digitally recorded, transcribed, and analyzed using a deductive coding approach to thematic analysis. RESULTS: Participants reported that the trusting relationship between barbers and their customers, which may not exist between Black men and health care providers, is a facilitator of collaborating with barbershop businesses to reach Black men for HIVST distribution. Participants recommended providing education for barbers on the use of HIVST, as well as how to inform self-testers about linkage to care following HIVST to build the credibility of the barbers in delivering the intervention. Participants also raised the issue of the cost of HIVST to barbershop customers as a potential barrier to implementation, as well as the possibility that the implementation of such interventions could be seen as out of place in a barbershop business venue. Participants also expressed a strong belief that compensation to barbershops and their employees should accompany any intervention. CONCLUSION: These findings suggest that barbershop business venues may provide an appropriate venue for HIVST promotion and distribution, though factors like cost, training, and incentivization of implementers are necessary to consider in implementation planning. Furthermore, partnerships between public health actors and the business community must be built on equitable engagement to ensure the long-term viability of these critical initiatives.

Factors affecting small dental business in rural Germany: Evidence from Hessen.

OBJECTIVES: To determine how social factors influence career decisions of dental service providers, particularly focusing on examining the impact of dentists' origins. METHODS: Online survey of Hessian panel dentists, with pairwise comparisons to a set of factors impacting their decision-making process. An Analytic Hierarchy Process examined the weighting of influencing drivers in career choice. RESULTS: Dentists from rural backgrounds were more likely to establish practices in rural areas than those from urban origins. Origin correlated with entrepreneurial intentions and a strong association of rural origin. Dentists who grew up in rural areas were 4.19 times more likely to start a business. CONCLUSION: These findings may support efficient resource allocation and support for rural dental businesses.

Assessing the impact of small firm dynamics on public mental health amid the pandemic in Latin America.

OBJECTIVE: The aim of our study is to examine the relationship between the economic activity of small firms and the mental well-being of the population in five Latin American countries in the early stages of the pandemic. METHODS: We utilize the search volume of certain keywords on Google Trends (GT), such as "boredom," "frustration," "loneliness," "sleep", "anxiety", and "depression", as an indicator of the well-being of the population. By examining the data from Facebook Business Activity Trends, we investigate how social attention reacts to the activity levels of different economic sectors. RESULTS: Increased business activity is generally associated with reduced levels of boredom, loneliness, sleep problems and anxiety. The effect on depression varies by sector, with positive associations concentrated in onsite jobs. In addition, we observe that strict Non-Pharmaceutical Interventions (NPIs) tend to exacerbate feelings of boredom and loneliness, sleep issues, and anxiety. CONCLUSIONS: Our findings suggest a strong association between different indicators of psychological well-being and the level of activity in different sectors of the economy. Given the essential role of small and medium-sized enterprises (SMEs) in generating employment, especially during crises like the pandemic, it is imperative that they remain resilient and adaptable to support economic recovery and job preservation. To accomplish this, policymakers need to focus on providing financial stability and support for SMEs, fostering social support networks within companies, and incorporating mental health services into workplace environments. This comprehensive strategy can alleviate mental health challenges and enhance public health resilience.

Managers in the context of small business growth: a qualitative study of working conditions and wellbeing.

PURPOSE: In view of the importance of managers' wellbeing for their leadership behaviour, employee health, and business effectiveness and survival, a better understanding of managers' wellbeing and working conditions is important for creating healthy and sustainable businesses. Previous research has mostly provided a static picture of managers' wellbeing and work in the context of small businesses, missing the variability and dynamism that is characteristic of this context. Therefore, the purpose of this study is to explore how managers in small companies perceive their working conditions and wellbeing in the context of business growth. METHODS: The study is based on qualitative semi-structured interviews with 20 managers from twelve small companies. Content and thematic analysis were applied. RESULTS: The findings indicate that a manager's working environment evolves from its initial stages and through the company's growth, leading to variations over time in the manager's experiences of wellbeing and work-life balance as well as changes in job demands and resources. Managers' working situation becomes less demanding and more manageable when workloads and working hours are reduced and a better work-life balance is achieved. The perceived improvement is related to changes in organizational factors (e.g. company resources), but also to individual factors (e.g. managers' increased awareness of the importance of a sustainable work situation). However, there were differences in how the working conditions and wellbeing changed over time and how organizational and individual resources affected the studied managers' wellbeing. CONCLUSIONS: This study shows that, in the context of small business, managers' working conditions and wellbeing are dynamic and are linked to growth-related changes that occur from the start of organizational activities and during periods of growth. In addition, the findings suggest that changes in managers' working conditions and wellbeing follow different trajectories over time because of the interaction between organizational and personal factors.

Web-based occupational stress prevention in German micro- and small-sized enterprises - process evaluation results of an implementation study.

BACKGROUND: Structural and behavioral interventions to manage work-related stress are effective in employees. Nonetheless, they have been implemented insufficiently, particularly in micro- and small-sized enterprises (MSE). Main barriers include a lack of knowledge and limited resources, which could potentially be overcome with simplified web-based alternatives for occupational stress prevention. However, there is a lack of implementation research about web-based prevention in realistic settings of MSE. OBJECTIVE: The aim of this study is to evaluate the implementation process and success of an integrated web-based platform for occupational stress prevention ("System P") and to identify potential barriers for its uptake and use in MSE in Germany. METHODS: This study with a mixed-methods approach investigates eight process-related outcomes in a quantitative part I (adoption, reach, penetration, fidelity/dose, costs, acceptability) and a qualitative part II (acceptability, appropriateness and feasibility). Part I has a pre-post design with two measurements (6 months apart) with 98 individual participants and part II consists of 12 semi-structured interviews with managers and intercorporate stakeholders. RESULTS: Part I revealed shortcomings in the implementation process. Adoption/Reach: Despite extensive marketing efforts, less than 1% of the contacted MSE responded to the offer of System P. A total of 40 MSE registered, 24 of which, characterized by good psychosocial safety climate, adopted System P. Penetration: Within these 24 MSE, 15% of the employees used the system. Fidelity/Dose: 11 MSE started a psychosocial risk-assessment (PRA), and no MSE finished it. The stress-management training (SMT) was started by 25 users and completed by 8. COSTS: The use of System P was free of charge, but the time required to engage with was an indirect cost. Part II added insights on the perception of the web-based intervention: Acceptance of System P by users and stakeholders was good and it was assessed as appropriate for MSE. Results for feasibility were mixed. CONCLUSIONS: Although System P was generally perceived as useful and appropriate, only a small number of contacted MSE implemented it as intended. Prior experience and sensitivity for occupational (stress) prevention were mentioned as key facilitators, while (perceived) indirect costs were a key barrier. Enabling MSE to independently manage stress prevention online did not result in successful implementation. Increasing external support could be a solution. ⁺ FULL PROJECT NAME: "PragmatiKK - Pragmatische Lösungen für die Implementation von Maßnahmen zur Stressprävention in Kleinst- und Kleinbetrieben" (= Pragmatic solutions for the implementation of stress prevention interventions in micro and small-sized enterprises). TRIAL REGISTRATION: German Register of Clinical Studies (DRKS) DRKS00026154, date of registration 2021-09-16.

Effects of occupational health promotion interventions on health-related outcomes among employees of small businesses and self-employed individuals: A systematic review.

BACKGROUND: Compared to workers of larger companies it is less clear what health promoting interventions might be beneficial for employees of small businesses and self-employed individuals. OBJECTIVE: Our aim was to critically appraise trials investigating health promotion programs among small business workers and self-employed individuals, by means of a systematic review. METHODS: We conducted a search of primary studies using MEDLINE, Web of Science, LIVIVO and the Cochrane library. Our assessment followed the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions and PRISMA. RESULTS: We identified six trials including 5,854 participants from Asia, North America and Australia. Most were of moderate methodological quality, only one was of low quality. Some of the supervised psycho-educational lifestyle programs focusing on individual behavior changes showed benefits in terms of stress reduction and increased physical activity levels among small enterprise employees. CONCLUSIONS: There is a huge knowledge gap on evidence-based health promotion interventions for self-employed and for small business workers, especially in Europe.

Perceptions and Bias of Small Business Leaders in Employing People with Different Types of Disabilities.

PURPOSE: Despite existing employment-related legislation and governmental programs, people with disabilities continue to face significant barriers to competitive employment. These obstacles are partially due to biases among employers regarding the contributions of people with disabilities and perceptions about accommodation costs, which can affect their hiring decisions. Existing research on employment barriers and facilitators often treats people with disabilities homogenously and focuses mainly on large companies. This study helps to fill these gaps by exploring the motivations and challenges small employers face when hiring people with disabilities and how their attitudes and willingness to hire vary based on disability type. METHODS: We surveyed business owners and decision-makers at companies with fewer than 100 employees resulting in a sample of 393 company respondents. Through descriptive analyses, we examined variations in respondents' willingness to hire and the prevailing attitudes among the company leaders sampled. We explored how employer attitudes can either hinder or support the hiring of people with disabilities. We conducted multivariate analysis to explore the connections among attitudinal barriers, facilitators, and willingness to hire individuals with various disabilities, reflecting disability's heterogeneous nature. RESULTS: Our findings reveal that, in terms of hiring people with disabilities, the most important concerns among employers are: inability to discipline, being unfamiliar with how to hire and accommodate, and uncertainty over accommodation costs. These concerns do not differ between employers covered by the Americans with Disabilities Act (ADA) and non-covered employers. However, ADA-coverage may make a difference as ADA-covered employers are more likely to say they would hire an applicant with a disability. We find that for small companies (less than 15 employees), the positive effect of the facilitators (positive perceptions about workers with disabilities) almost completely offsets the negative effect of the barriers. However, for the larger companies, the marginal effect for an additional barrier is significantly more predictive than for an additional facilitator. Among the disabilities we examined, employers are least likely to hire someone with blindness, followed by mental health disabilities, intellectual disabilities, deafness, and physical disabilities, underscoring that employers do not view all types of disabilities as equally desirable at work. CONCLUSIONS: Understanding small employers' underlying concerns and effectively addressing those factors is crucial for developing effective intervention strategies to encourage small employers to hire and retain people with different disabilities. Our results suggest greater openness among ADA-covered employers to hiring people with disabilities, but the perceived barriers indicate a need for ongoing information on effective intervention strategies to increase disability hiring among all small employers.

Preventive health measures in small and medium-sized enterprises: A scoping review on implementation strategies.

OBJECTIVE: To describe implementation strategies for preventive health measures in SMEs and the effectiveness of the strategies on implementation outcomes. METHODS: A literature search was performed in multiple electronic databases. Studies published between 2000 and 2021 that evaluated the implementation of preventive health measures in SMEs were included. Classification of implementation strategies was based on two complementary classification systems. RESULTS: Nineteen studies, of which 5 RCTs were included. Eighteen distinct implementation strategies were reported. All studies applied a combination of implementation strategies, and nearly all reported a positive effect on one or more implementation outcomes: sustainability, acceptability, feasibility, penetration, fidelity, adoption, and appropriateness. CONCLUSIONS: Overall, a positive effect of combined implementation strategies on the implementation outcome(s) was found. The 'distribution of educational materials' and 'provide ongoing consultation' combined show positive effects on sustainability.

Rise of the Allotrope Simple Model: Update from 2023 Fall Allotrope Connect.

The Allotrope Foundation (AF) started as a group of pharmaceutical companies, instrument, and software vendors that set out to simplify the exchange of data in the laboratory. After a decade of work, they released products that have found adoption in various companies. Most recently, the Allotrope Simple Model (ASM) was developed to speed up and widen the adoption. As a result, the Foundation has recently added chemical companies and, importantly, is reworking its business model to lower the entry barrier for smaller companies. Here, we present the proceedings from the Allotrope Connect Fall 2023 conference and summarize the technical and organizational developments at the Foundation since 2020.

Determinants of the transition towards circular economy in SMEs: a sustainable supply chain management perspective.

Small and medium-sized businesses (SMEs) increasingly know the benefits of improving resource efficiency and closing loops. These benefits include lowering material costs, establishing competitive advantages, and gaining access to new markets. As a consequence of implementing new regulations, manufacturing companies, particularly those in the automobile industry, are compelled to modify and change their business practices related to the circular economy (CE). More stringent the implementation of environmentally responsible policies and strengthening environmental regulations. CE is the most important factor in improving environmental conditions since it reduces waste and boosts output. This facet calls for the attention of fresh academics and policymakers with years of relevant expertise. Recent studies have investigated how green logistics management might improve a company's overall performance in terms of environmental responsibility. However, we believe that the connection between environmentally responsible companies is not a direct one but rather one that is mediated by the practices of circular economies. We investigate the direct and indirect effects of the environmentally responsible impact of proper logistics management on organizations' overall environmental performance via the application of circular economy practices. Our theoretical underpinnings are the resource-based viewpoint and the resource dependence theory. This research also investigates whether or not the traceability of the supply chain has a mitigating influence on the connections. We evaluated the hypotheses using the PLS-SEM method, drawing on the empirical data provided by 245 Chinese factories considered modest or medium size. The results demonstrate that the management of green logistics has a constructive effect on circular economy practices and businesses' sustainability performance. In addition, although it greatly impacts circular economy practice among SMEs, supply chain traceability does not attenuate the connection between eco-friendly supply chain management and environmental impact. Green logistics management in SMEs is linked to improved sustainability performance via the circular economy practice. To further verify the efficacy of the mediation, we also ran the sober test. Our results strengthen knowledge of circular economy, environmentally friendly logistics management practices, and sustainability performance while advancing natural resource-based planning and the resource dependence theory, which are the two approaches. Given the scarcity of information research analyzing the interplay between these factors, our results are very significant.

Testing biasedness of self-reported microbusiness innovation in the annual business survey.

This study tests for potential bias in self-reported innovation due to the inclusion of a research and development (R&D) module that only microbusinesses (less than 10 employees) receive in the Annual Business Survey (ABS). Previous research found that respondents to combined innovation/R&D surveys reported innovation at lower rates than respondents to innovation-only surveys. A regression discontinuity design is used to test whether microbusinesses, which constitute a significant portion of U.S. firms with employees, are less likely to report innovation compared to other small businesses. In the vicinity of the 10-employee threshold, the study does not detect statistically significant biases for new-to-market and new-to-business product innovation. Statistical power analysis confirms the nonexistence of biases with a high power. Comparing the survey design of ABS to earlier combined innovation/R&D surveys provides valuable insights for the proposed integration of multiple Federal surveys into a single enterprise platform survey. The findings also have important implications for the accuracy and reliability of innovation data used as an input to policymaking and business development strategies in the United States.

Usability and feasibility of a take-home methadone web-application for opioid treatment program patients: A Small Business Innovation Research mixed methods study.

BACKGROUND: Most patients in opioid treatment programs (OTPs) attend daily for observed dosing. A Stage IA (create and adapt) and a Stage IB (feasibility and pilot) mixed method studies tested a web-application (app) designed to facilitate access to take-home methadone. METHODS: A Stage IA, intervention development study, used qualitative interviews to assess the usability (ease of use) and feasibility (ability to implement) of a take-home methadone app. The Stage IA market research was a two-week test with 96 patient participants from four OTPs. Qualitative interviews were completed with 20 systematically selected individuals who used the take-home app and 20 OTP clinicians (five each from the four OTPs). The Stage IB Small Business Innovation Research (SBIR) study (24 patients and 8 clinicians in a single OTP) included quantitative assessments of the app's usability, acceptability, appropriateness, and feasibility. Thematic analysis coded participant and staff assessments of the take-home app. RESULTS: Stage IA patients (mean age = 41 years; 52 % men, 57 % White) and IB patients (mean age = 38 years, 54 % men, 79 % White) described the app as "easy to use." Compared to unsupervised take-homes, some patients preferred using the take-home app. In Stage IB, patients rated the app highly on standardized measures of usability, acceptability, appropriateness, and feasibility. Clinician ratings were more ambivalent. Patients rated in-clinic dosing as more disruptive than unsupervised take-homes and take-homes using the app. DISCUSSION: A Stage IA study informed the development and maturation of a Stage IB feasibility pilot study. Overall, the take-home app's usability, acceptability, appropriateness, and feasibility were rated positively. Clinical staff ratings were less positive, but individuals commented that using the app a) enhanced patient quality of life, b) provided new tools for counselors, and c) offered competitive advantages. The SBIR award enhanced market research with more complete and systematic data collection and analysis.

Increased contribution of small companies to late-entry drugs: a changing trend in FDA-approved drugs during the 2020s.

Small- and medium-sized enterprises (SMEs) have significantly boosted innovative drug discovery, whereas large pharmaceutical companies have focused on incremental drug innovation. I explored the evolving role of SMEs in late-entry drug discovery. A comparative analysis of new drugs approved by the US Food and Drug Administration (FDA) during the 2020s with those approved previously revealed that SMEs have expanded their role to late-entry drug discovery while maintaining their contribution to first-in-target drug discovery. I analyzed the characteristics of SMEs responsible for the discovery of late-entry drugs approved during the 2020s, and the modality, market entry timing, and differentiation points of the drugs. I also discuss encompassing opportunities for SMEs, pharmaceutical industry future alliance strategies, and the importance of startup promotion measures.

Affordable Health Insurance Options for Small Business and Low-Wage Workers Remains Elusive: Experience With New Health Reimbursement Arrangements in New Jersey.

Low-wage workers and those employed by small businesses are least likely to be offered health insurance coverage and they are over-represented among the uninsured. Two new forms of health reimbursement arrangements (HRAs) that allow employers to help fund individual market coverage for workers have been touted as breakthrough strategies to help fill this gap. Despite several years of experience and low adoption, little is known about employer understanding of or views about these HRA options. Consistent with other evidence, only 11.8% of New Jersey employers we surveyed offer or plan to offer either of the HRA options. Few respondents (18.5%) report familiarity with either option. Even among businesses that offer or plan to offer this form of HRA, under half (47.6%) say that they are familiar with them. Other reasons cited for not offering these options include broker advice and complexity. While more investigation is needed, these findings suggest that new strategies should be explored to fill the gap in health insurance for low-wage and small business employees.

A qualitative study of factors that managers in small companies consider important for their wellbeing.

PURPOSE: Given the importance of small businesses for society, and the significance of managers' wellbeing for employee health, leadership, and business performance, more knowledge is needed on the sources of managers' wellbeing. This study explored factors within the small business context that were perceived by managers to hinder or enable their wellbeing. METHODS: Data were collected through qualitative semi-structured interviews with 20 managers from 12 small companies, and analysed with content analysis. RESULTS: The factors that these managers in small businesses experienced as enhancing or hindering their personal wellbeing covered five categories: demands and resources in the daily managerial work, achievement of results, social factors, organizational factors, and individual factors. CONCLUSIONS: The specific context of managerial work in small companies encompasses unique factors. For instance, the small company managers' wellbeing was affected by vulnerability due to the smallness of the business and the absence of available resources. Simultaneously, a small company context provided a strong social climate and close relationships with employees and customers that strengthened the managers' wellbeing. The findings suggest that the availability of financial, personnel, and organizational resources varies between small companies of different size, which may have implications for small business managers' work and wellbeing.

How can digital finance boost enterprises' high-quality development?: evidence from China.

As a new industry derived from the traditional financial system and enhanced by emerging technologies, digital finance is significant in microenterprise development. Based on the 2011-2018 Digital Inclusive Finance Index of Peking University, we examine the mechanism-inventory optimization and incremental innovation. We use the data of small and medium-sized enterprises to reveal the effect of digital finance-mismatch correction and defect improvement. The study results show that digital financing significantly improves enterprises' high-quality development. Further research has revealed that digital finance can effectively correct scale, attribute, phase, and industry mismatches. Digital finance alleviates financing constraints, solves the expensive financing problem, and pushes enterprises to deleverage in the economic development process. However, digital finance is still limited for companies with high financing constraints and leverage. Moreover, financial regulation can significantly improve the economic performance of digital finance. The findings provide reliable empirical evidence and policy inspiration for promoting digital finance development, deepening the supply-side structural reform of finance, better serving the real economy, and achieving high-quality economic development.

Microenterprise and home care for older adults in England and Wales: A partial revolution?

Paid carers play an important role in helping older adults with care needs to remain living in their own homes. This paper examines changes in the home care field, specifically the emergence of self-employed care entrepreneurs ('microentrepreneurs'). To do this, it employs Bourdieu's concepts of field, capital and habitus. Drawing on 105 semi-structured interviews with stakeholders working in home care, the paper describes how the interaction of changes to field structures, and altered practices of care have challenged the taken-for-granted acceptance of traditional, transactional forms of care provision. This process has been highly dependent on local state actors, their ability to mobilise relevant forms of capital and the factors which shaped their habitus. It should be seen within the context of changes to local field structures and the hierarchical classification processes which underpin them. These changes threaten the distribution of capital in the home care field in ways that are beneficial to microentrepreneurs. Bourdieu might categorise these developments as 'partial revolutions', which do not challenge the fundamental axioms of the field. However, for care entrepreneurs, formerly employed as low-paid home-care workers, a revolution that is only partial may be better than none at all.

Strategic trends of pharmaceutical companies: A growth model through regional focus and inter-regional alliances.

Pharmaceutical companies face challenges in business continuity resulting from declining research and development productivity. This study examines the relationship between two strategic pillars: region and therapeutic area, while considering company size. The results indicate that a therapeutic area focus is an effective strategy for small/medium-sized companies, whereas a regional focus is effective for larger companies. These findings highlight the limitations of the traditional global pharmaceutical model from 2004 to 2018 and aim to contribute to the future corporate strategic planning of these companies.

The Bite of HOPE Small Food Business Development Program: a clinic-based culinary medicine program targeting local business owners.

Culinary medicine is a popular approach to health promotion, but most programs focus on patient or provider-facing education. While laudable, these efforts do not represent the full potential for culinary medicine to impact community health. We describe a novel approach to culinary medicine at a federally qualified health center (FQHC), the HOPE Clinic: Bite of HOPE Small Food Business Development (SFBD) program. Describe the design and implementation of the Bite of HOPE SFBD program and examine initial response to the program through interviews and focus groups with past participants. The SFBD program aims to create healthy food outlets by supporting local small businesses with education, resources, and mentorship support. Former participants in the SFBD program were invited to participate in focus groups and interviews exploring their experience and perceived program impact. Three focus groups (n = 10) and nine in-depth interviews were conducted. Most participants were Black or Hispanic and all operated their businesses in the community surrounding HOPE Clinic. Five themes emerged from the data including perceived program purpose, program discovery, motivating factors to participation, perceived program impact, and suggestions for improvement. Participants expressed high satisfaction with the program and positive changes in both business development and personal eating habits. There is an opportunity to leverage the culinary medicine model to support local small food business and improve community health. The Bite of HOPE SFBD program offers an example of how clinic-based resources can expand into the surrounding environment.

Culinary medicine is an increasingly popular way to teach individuals about healthy eating, but most programs offer classes only to patients or healthcare providers. This study explores a new type of culinary medicine program that focuses on improving community health by teaching small food business owners about healthy eating and sustainability. In this paper, we describe the small food business program and explore how business owners reacted to participating in the program. We discussed the small food business development (SFBD) program with 19 former participants through focus groups and interviews. Former participants expressed high satisfaction with the program and positive changes in both business development and personal eating habits. Program suggestions were focused on ways to increase access to the program information. The SFBD program described here offers an example of how culinary medicine can be used to enhance community nutrition and economic health by offering education and support to local food purveyors and professionals.

Barriers and Challenges to Human Factors/Ergonomics Knowledge Transfer to Small Business Enterprises in an Industrially Developing Country.

OCCUPATIONAL APPLICATIONWe found that small business enterprises (SBEs) face intra- and extra-organizational barriers in different dimensions related to their work system to practically implement human factors/ergonomics (HFE) knowledge transfer and to achieve its benefits in an industrially developing country. Utilizing a three-zone lens, we evaluated the feasibility of overcoming the barriers identified by stakeholders, especially ergonomists. To overcome the identified barriers in practice, three types of macroergonomics interventions (top-down, middle-out, and bottom-up) were distinguished through macroergonomics theory. The bottom-up approach of macroergonomics, as a participatory HFE intervention, was considered as the entry point to overcome the perceived barriers in the first zone of the lens, which included such themes as lack of competence, lack of involvement and interaction, and inefficient training and learning approaches. This approach focused on improving emotional literacy as a care zone among the small business enterprise personnel.

Background: The human factors/ergonomics (HFE) knowledge transfer process is one of the potential challenges for organizations in industrially developing countries (IDCs), especially in small business enterprises (SBEs).Purpose: We explored perceived barriers and challenges to the practical implementation of HFE knowledge transfer to SBEs in Iran, as an IDC, to improve their work systems.Methods: An exploratory qualitative study was conducted using a conventional content analysis. To identify perceived barriers, we conducted individual interviews (n = 38) and a focus-group discussion (n = 17) with the participation of the SBEs personnel and the officials of related organizations. Inductive content analysis was used for data analysis. We then categorized the identified perceived barriers (themes) to determine the feasibility of overcoming them.Results: Regarding perceived barriers, the following nine themes were extracted: lack of competence, resistance to change, technological infrastructure problems, lack of involvement and interaction, using an inappropriate mode of knowledge, lack of culture-building about HFE, inefficient training and learning approaches, lack of scientific management, and extra-organizational problems. Further, a three-zone lens was identified for the extracted themes to check the feasibility of overcoming them.Conclusions: We identified nine intra- and extra-organizational barriers in the HFE knowledge transfer process to SBEs. We further evaluated the ways of overcoming perceived barriers defined in the three-zone lens to adapt them for building creative workplace culture zones (care, creative, and improvement). We distinguished three types of macroergonomics interventions (top-down, middle-out, and bottom-up) and three supporting strategies, including, knowledge, management and employees, and participatory HFE.